Effects of dipeptidyl peptidase-4 inhibitors on beta-cell function and insulin resistance in type 2 diabetes: meta-analysis of randomized controlled trials.
Dipeptidyl peptidase-4 (DPP-4) inhibitors are a novel family of glucose-lowering agents. Accumulating evidence suggests that DPP-4 inhibitors preserve pancreatic beta-cell function, but results in previous studies have been inconsistent. We assessed the effects of DPP-4 inhibitors on the homoeostasis model assessment beta-cell function (HOMA-B) or insulin resistance (HOMA-IR) index in patients with type 2 diabetes through a systematic review and meta-analysis of randomized controlled trials (RCTs). Relevant articles were identified from PubMed, Embase, and Cochrane Library databases up to December 27, 2016. We calculated weighted mean differences (WMDs) and 95% confidence intervals (CIs) in each included trial and pooled the data using a random-effects model. Fifty-two trials were included in the present analysis. Compared with placebo control, DPP-4 inhibitors as monotherapy significantly improved HOMA-B (WMD 9.15; 95% CI 7.48, 10.81). Similarly, DPP-4 inhibitors as add-on therapy in combination with other drugs showed significant improvement in HOMA-B (WMD 9.04; 95% CI 5.72, 12.37). However, we found no significant improvement in HOMA-IR following treatment with DPP-4 inhibitors as mono-therapy or as add-on therapy. In conclusion, DPP-4 inhibitors as monotherapy or as add-on therapy significantly improved beta-cell function but had no significant effect on insulin resistance in type 2 diabetes.
Diabetic Foot Care Center, West China Hospital, Sichuan University, Guoxue Lane No. 37, Chengdu, Sichuan, China.|Department of Radiology, West China Hospital, Sichuan University, Guoxue Lane No. 37, Chengdu, Sichuan, China.
Xiafei
X
Lyu
Global Medical Affairs, Merck Sharp &Dohme China, Shanghai, China.
Xiaolin
X
Zhu
Global Medical Affairs, Merck Sharp &Dohme China, Shanghai, China.
Bin
B
Zhao
Chinese Evidence-Based Medicine Centre, Chinese Cochrane Center, West China Hospital, Sichuan University, Guoxue Lane No. 37, Chengdu, Sichuan, China.
Liang
L
Du
Diabetic Foot Care Center, West China Hospital, Sichuan University, Guoxue Lane No. 37, Chengdu, Sichuan, China.|Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Guoxue Lane No. 37, Chengdu, Sichuan, China.
Dawei
D
Chen
Diabetic Foot Care Center, West China Hospital, Sichuan University, Guoxue Lane No. 37, Chengdu, Sichuan, China.|Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Guoxue Lane No. 37, Chengdu, Sichuan, China.
Chun
C
Wang
Chinese Evidence-Based Medicine Centre, Chinese Cochrane Center, West China Hospital, Sichuan University, Guoxue Lane No. 37, Chengdu, Sichuan, China.
Guanjian
G
Liu
Diabetic Foot Care Center, West China Hospital, Sichuan University, Guoxue Lane No. 37, Chengdu, Sichuan, China.|Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Guoxue Lane No. 37, Chengdu, Sichuan, China.
Xingwu
X
Ran
D015415:Biomarkers; D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000378:metabolism*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000187:drug effects* / Q000378:metabolism*; D017594:Publication Bias; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D015415:Biomarkers; D001786:Blood Glucose; D054873:Dipeptidyl-Peptidase IV Inhibitors