Endocrinology and Metabolism

Original Articles

Clinical Study
Comparative Renal Effects of Dipeptidyl Peptidase-4 Inhibitors and Sodium-Glucose Cotransporter 2 Inhibitors on Individual Outcomes in Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis: Jae Hyun Bae, Eun-Gee Park, Sunhee Kim, Sin Gon Kim, Seokyung Hahn, Nam Hoon Kim; Endocrinol Metab. 2021;36(2):388-400. Published online March 31, 2021; DOI: https://doi.org/10.3803/EnM.2020.912

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359 Download
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16 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
To compare the renal effects of dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium-glucose cotransporter 2 (SGLT2) inhibitors on individual outcomes in patients with type 2 diabetes.
Methods
We searched electronic databases (MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials) from inception to June 2019 to identity eligible randomized controlled trials of DPP-4 inhibitors or SGLT2 inhibitors that reported at least one kidney outcome in patients with type 2 diabetes. Outcomes of interest were microalbuminuria, macroalbuminuria, worsening nephropathy, and end-stage kidney disease (ESKD). We performed an arm-based network meta-analysis using Bayesian methods and calculated absolute risks and rank probabilities of each treatment for the outcomes.
Results
Seventeen studies with 87,263 patients were included. SGLT2 inhibitors significantly lowered the risks of individual kidney outcomes, including microalbuminuria (odds ratio [OR], 0.64; 95% credible interval [CrI], 0.41 to 0.93), macroalbuminuria (OR, 0.48; 95% CrI, 0.24 to 0.72), worsening nephropathy (OR, 0.65; 95% CrI, 0.44 to 0.91), and ESKD (OR, 0.65; 95% CrI, 0.46 to 0.98) as compared with placebo. However, DPP-4 inhibitors did not lower the risks. SGLT2 inhibitors were considerably associated with higher absolute risk reductions in all kidney outcomes than DPP-4 inhibitors, although the benefits were statistically insignificant. The rank probabilities showed that SGLT2 inhibitors were better treatments for lowering the risk of albuminuria and ESKD than placebo or DPP-4 inhibitors.
Conclusion
SGLT2 inhibitors were superior to DPP-4 inhibitors in reducing the risk of albuminuria and ESKD in patients with type 2 diabetes.

Citations

Citations to this article as recorded by

Therapie des Typ-2-Diabetes
Rüdiger Landgraf, Jens Aberle, Andreas L. Birkenfeld, Baptist Gallwitz, Monika Kellerer, Harald H. Klein, Dirk Müller-Wieland, Michael A. Nauck, Tobias Wiesner, Erhard Siegel
Die Diabetologie.2024; 20(2): 212. CrossRef
Ipragliflozin and sitagliptin differentially affect lipid and apolipoprotein profiles in type 2 diabetes: the SUCRE study
Mototsugu Nagao, Jun Sasaki, Kyoko Tanimura-Inagaki, Ichiro Sakuma, Hitoshi Sugihara, Shinichi Oikawa
Cardiovascular Diabetology.2024;[Epub] CrossRef
Comparative Effect of Glucose-Lowering Drugs for Type 2 Diabetes Mellitus on Stroke Prevention: A Systematic Review and Network Meta-Analysis
Ji Soo Kim, Gyeongsil Lee, Kyung-Il Park, Seung-Won Oh
Diabetes & Metabolism Journal.2024; 48(2): 312. CrossRef
Therapy of Type 2 Diabetes
Rüdiger Landgraf, Jens Aberle, Andreas L. Birkenfeld, Baptist Gallwitz, Monika Kellerer, Harald H. Klein, Dirk Müller-Wieland, Michael A. Nauck, Tobias Wiesner, Erhard Siegel
Experimental and Clinical Endocrinology & Diabetes.2024;[Epub] CrossRef
Therapie des Typ-2-Diabetes
Rüdiger Landgraf, Jens Aberle, Andreas L. Birkenfeld, Baptist Gallwitz, Monika Kellerer, Harald H. Klein, Dirk Müller-Wieland, Michael A. Nauck, Tobias Wiesner, Erhard Siegel
Die Diabetologie.2023; 19(5): 658. CrossRef
Renoprotective Effect of Thai Patients with Type 2 Diabetes Mellitus Treated with SGLT-2 Inhibitors versus DPP-4 Inhibitors: A Real-World Observational Study
Apichaya Chanawong, Suriyon Uitrakul, Supatcha Incomenoy, Natnicha Poonchuay, Rizky Abdulah
Advances in Pharmacological and Pharmaceutical Sciences.2023; 2023: 1. CrossRef
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Daijin Huang, Yumei Li, Jing Ye, Chang Liu, Dongyan Shen, Yunhui Lv
Medicine.2023; 102(52): e36298. CrossRef
New trends in the approach to the treatment of type 2 diabetes - observations and benefits in the outpatient practice of a diabetologist
Pavel Weber, Hana Meluzínová, Dana Weberová
Klinická farmakologie a farmacie.2022; 35(4): 118. CrossRef
Comparative efficacy of novel antidiabetic drugs on cardiovascular and renal outcomes in patients with diabetic kidney disease: A systematic review and network meta‐analysis
Hongwei Cao, Tao Liu, Li Wang, Qiuhe Ji
Diabetes, Obesity and Metabolism.2022; 24(8): 1448. CrossRef
Therapie des Typ-2-Diabetes
Rüdiger Landgraf, Jens Aberle, Andreas L. Birkenfeld, Baptist Gallwitz, Monika Kellerer, Harald H. Klein, Dirk Müller-Wieland, Michael A. Nauck, Tobias Wiesner, Erhard Siegel
Die Diabetologie.2022; 18(5): 623. CrossRef
Significant reduction in chronic kidney disease progression with sodium‐glucose cotransporter‐2 inhibitors compared to dipeptidyl peptidase‐4 inhibitors in adults with type 2 diabetes in a UK clinical setting: An observational outcomes study based on inte
Iskandar Idris, Ruiqi Zhang, Jil B. Mamza, Mike Ford, Tamsin Morris, Amitava Banerjee, Kamlesh Khunti
Diabetes, Obesity and Metabolism.2022; 24(11): 2138. CrossRef
Therapy of Type 2 Diabetes
Rüdiger Landgraf, Jens Aberle, Andreas L. Birkenfeld, Baptist Gallwitz, Monika Kellerer, Harald Klein, Dirk Müller-Wieland, Michael A. Nauck, Tobias Wiesner, Erhard Siegel
Experimental and Clinical Endocrinology & Diabetes.2022; 130(S 01): S80. CrossRef
Molecular Mechanistic Pathways Targeted by Natural Compounds in the Prevention and Treatment of Diabetic Kidney Disease
Kaixuan Zhou, Xue Zi, Jiayu Song, Qiulu Zhao, Jia Liu, Huiwei Bao, Lijing Li
Molecules.2022; 27(19): 6221. CrossRef
Lower risk of gout in sodium glucose cotransporter 2 (SGLT2) inhibitors versus dipeptidyl peptidase-4 (DPP4) inhibitors in type-2 diabetes
Jiandong Zhou, Xuejin Liu, Oscar Hou-In Chou, Lifang Li, Sharen Lee, Wing Tak Wong, Qingpeng Zhang, Carlin Chang, Tong Liu, Gary Tse, Fengshi Jing, Bernard Man Yung Cheung
Rheumatology.2022;[Epub] CrossRef
New Era for Renal-Protective Therapy in Type 2 Diabetes: Better Renal Outcomes in Patients with Type 2 Diabetes Taking Sodium-Glucose Cotransporter 2 Inhibitors versus Dipeptidyl Peptidase-4 Inhibitors
Chan-Hee Jung
Endocrinology and Metabolism.2021; 36(2): 339. CrossRef
Efficacy / safety balance of DPP-4 inhibitors versus SGLT2 inhibitors in elderly patients with type 2 diabetes
André J. Scheen
Diabetes & Metabolism.2021; 47(6): 101275. CrossRef

Clinical Study
Association between Circulating Irisin and C-Reactive Protein Levels: A Systematic Review and Meta-Analysis: Elham Eslampour, Farzad Ebrahimzadeh, Amir Abbasnezhad, Mohammad Zeinali Khosroshahi, Razieh Choghakhori, Omid Asbaghi; Endocrinol Metab. 2019;34(2):140-149. Published online June 24, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.2.140

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Abstract PDF Supplementary Material PubReader ePub

Background

Although previous studies have demonstrated that irisin plays an anti-inflammatory role in the body, conflicting results have been reported regarding the correlation between serum levels of irisin and C-reactive protein (CRP). The present meta-analysis was conducted to further investigate the correlation between irisin and CRP levels.

Methods

We systematically searched PubMed, the Cochrane Library, Web of Science, Embase, SCOPUS, and Ovid to retrieve studies assessing the correlation between irisin and CRP levels. Meta-analyses were performed using a random-effects model, and the I² index was used to evaluate heterogeneity.

Results

Of the 428 studies that were initially found, 14 studies with 2,530 participants met the inclusion criteria for the meta-analysis. The pooled effect size was calculated as 0.052 (95% confidence interval, −0.047 to 0.152; P=0.302). Subgroup analyses identified s ignificant, positive, but weak correlations between CRP and irisin levels in cohort studies, studies conducted among healthy participants, studies in which the male-to-female ratio was less than 1, in overweight or obese subjects, and in studies with a sample size of at least 100 participants.

Conclusion

The present meta-analysis found no overall significant correlation between irisin and CRP levels, although a significant positive correlation was found in overweight or obese subjects. Well-designed studies are needed to verify the results of the present meta-analysis.

Citations

Citations to this article as recorded by

Zinc Supplementation in Individuals with Prediabetes and type 2 Diabetes: a GRADE-Assessed Systematic Review and Dose-Response Meta-analysis
Matin Nazari, Mahlagha Nikbaf-Shandiz, Fereshteh Pashayee-Khamene, Reza Bagheri, Kian Goudarzi, Navid Vahid Hosseinnia, Sina Dolatshahi, Hossein Salehi Omran, Niusha Amirani, Damoon Ashtary-larky, Omid Asbaghi, Matin Ghanavati
Biological Trace Element Research.2023;[Epub] CrossRef
Irisin reduces inflammatory signaling pathways in inflammation-mediated metabolic syndrome
John J. Slate-Romano, Naohiro Yano, Ting C. Zhao
Molecular and Cellular Endocrinology.2022; 552: 111676. CrossRef
Circulating Irisin Levels in Patients with Chronic Plaque Psoriasis
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Xin Zhang, Can Hu, Hai-ming Wu, Zhen-guo Ma, Qi-zhu Tang
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Hongyu Li, Qisijing Liu, Zhiyong Zou, Qiao Chen, Wanzhou Wang, Andrea A. Baccarelli, Furong Deng, Xinbiao Guo, Shaowei Wu
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Complementary Therapies in Medicine.2019; 46: 210. CrossRef

Diabetes
Effects of Dipeptidyl Peptidase-4 Inhibitors on Renal Outcomes in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis: Jae Hyun Bae, Sunhee Kim, Eun-Gee Park, Sin Gon Kim, Seokyung Hahn, Nam Hoon Kim; Endocrinol Metab. 2019;34(1):80-92. Published online March 21, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.1.80

7,564 View
266 Download
36 Web of Science
38 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background

To investigate the effects of dipeptidyl peptidase-4 (DPP-4) inhibitors on renal outcomes in patients with type 2 diabetes.

Methods

MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched to identify randomized controlled trials (RCTs) of DPP-4 inhibitors from inception to September 2017. We selected eligible RCTs comparing DPP-4 inhibitors with placebo or other antidiabetic agents and reporting at least one renal outcome. A meta-analysis was conducted to calculate standardized mean differences, weighted mean differences (WMDs), relative risks (RRs), and 95% confidence intervals (CIs) for each renal outcome.

Results

We included 23 RCTs with 19 publications involving 41,359 patients. Overall changes in urine albumin-to-creatinine ratio were comparable between DPP-4 inhibitors and controls (P=0.150). However, DPP-4 inhibitors were associated with significantly lower risk of incident microalbuminuria (RR, 0.89; 95% CI, 0.80 to 0.98; P=0.022) and macroalbuminuria (RR, 0.77; 95% CI, 0.61 to 0.97; P=0.027), as well as higher rates of regression of albuminuria (RR, 1.22; 95% CI, 1.10 to 1.35; P<0.001) compared with controls. Although DPP-4 inhibitors were associated with small but significantly lower estimated glomerular filtration rate (WMD, −1.11 mL/min/1.73 m²; 95% CI, −1.78 to −0.44; P=0.001), there was no difference in the risk of end-stage renal disease between two groups (RR, 0.93; 95% CI, 0.76 to 1.14; P=0.475).

Conclusion

DPP-4 inhibitors had beneficial renal effects mainly by reducing the risk of development or progression of albuminuria compared with placebo or other antidiabetic agents.

Citations

Citations to this article as recorded by

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