Abstract
BackgroundDipeptidyl peptidase-4 inhibitors (DPP-4i) provide a unique antihyperglycemic effect by regulating incretin peptides in type 2 diabetes mellitus (T2DM) patients who are inadequately controlled with insulin therapy. The aim of this study was to investigate the impact of DPP-4i on leptin concentrations in subjects with T2DM.MethodsRandomized controlled trials (RCTs) with comparators were systematically searched through PubMed, Embase, and the Cochrane Library. Quantitative analysis was performed with a fixed or random-effects model according to heterogeneity. Publication bias was evaluated by using the standard methods for sensitivity analysis.ResultsTen trials with 698 patients with T2DM were included. Pooled analysis demonstrated that DPP-4i did not significantly change leptin concentrations (1.31 ng/mL, 95 % CI − 0.48 to 3.10). DPP-4i exerted effects on modulating leptin levels compared to active comparators (0.21 ng/mL, 95 % CI − 1.37 to 1.78). Meta-analysis was powerful and stable after sensitivity analysis.ConclusionsDPP-4i did not modulate leptin concentrations in T2DM and exerted no stronger effects than traditional antidiabetic agents.
Highlights
Type 2 diabetes mellitus (T2DM) is a common metabolic disease characterized by hyperglycemia and is often accompanied by obesity
The efficacy and safety of DPP-4 inhibitors have been proved by several randomized controlled trials, demonstrating improved glucose control with a low risk of hypoglycemia [14]. It remains unknown whether DPP-4 inhibitors could modulate leptin and to what extent compared to other antidiabetic agents
A study was identified if it was a randomized controlled study comparing Dipeptidyl peptidase-4 inhibitors (DPP-4i) with placebo or other antidiabetic agents, if it reported leptin levels with DPP-4i treatment, and if it was conducted in patients with type 2 diabetes mellitus (T2DM)
Summary
Type 2 diabetes mellitus (T2DM) is a common metabolic disease characterized by hyperglycemia and is often accompanied by obesity. Novel glucose-lowering drugs including sodium-glucose cotransporter 2 (SGLT2) inhibitors, glucagon-like peptide 1 (GLP-1) receptor agonists, and Dipeptidyl peptidase-4 inhibitors (DPP-4i) have become available These agents provide protective effects by reducing blood glucose levels and improving insulin resistance [10, 11]. The efficacy and safety of DPP-4 inhibitors have been proved by several randomized controlled trials, demonstrating improved glucose control with a low risk of hypoglycemia [14] It remains unknown whether DPP-4 inhibitors could modulate leptin and to what extent compared to other antidiabetic agents. Dipeptidyl peptidase-4 inhibitors (DPP-4i) provide a unique antihyperglycemic effect by regulating incretin peptides in type 2 diabetes mellitus (T2DM) patients who are inadequately controlled with insulin therapy. The aim of this study was to investigate the impact of DPP-4i on leptin concentrations in subjects with T2DM
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