Significant Differences in Effects of Sitagliptin Treatment on Body Weight and Lipid Metabolism Between Obese and Non-Obese Patients With Type 2 Diabetes

Abstract

Background: We previously reported that HbA1c levels and body weight significantly decreased by 0.6% and by 0.8 kg, respectively, at 6 months after sitagliptin treatment started. We found a significant and negative correlation between change in body weight and body mass index (BMI) at baseline. Methods: We retrospectively sub-analyzed effects of 6-month treatment with sitagliptin on glucose and lipid metabolism, blood pressure, body weight and renal function in patients with type 2 diabetes, by dividing 173 type 2 diabetic subjects into obese group (BMI is greater than or equal to 25) and non-obese group (BMI < 25). Results: At baseline, obese group was significantly younger than non-obese group. Diastolic blood pressure, low-density lipoprotein-cholesterol (LDL-C), triglyceride (TG), and estimated glomerular filtration rate (eGFR) in obese group were significantly higher than in non-obese group. Serum high-density lipoprotein-cholesterol (HDL-C) in obese group was significantly lower than in non-obese group. At 6 months after the start of sitagliptin use, body weight significantly decreased in obese group, while body weight did not change in non-obese group. HbA1c significantly decreased in both groups. Serum HDL-C significantly decreased in obese group, while serum HDL-C did not change in non-obese group. Serum TG significantly decreased in obese group, while serum TG significantly increased in non-obese group. Change in serum TG was significantly and inversely correlated with BMI at baseline. Conclusions: We found significant differences in effects of sitagliptin treatment on body weight and lipid metabolism between obese and non-obese patients with type 2 diabetes. Sitagliptin improved HbA1c regardless of the existence of obesity. In obese people, sitagliptin significantly reduced body weight and serum TG. Sitagliptin reduced serum TG in a baseline-BMI-dependent manner. J Endocrinol Metab. 2014;4(5-6):136-142 doi: http://dx.doi.org/10.14740/jem243w