Influence of dipeptidyl peptidase-4 inhibitor on fat metabolism and Its role in glucose metabolic regulation: Results of the study
Abstract. The complex nature of type 2 diabetes mellitus (T2DM) requires a more detailed study of its development mechanisms and the search for effective treatments for timely intervention in its clinical course.P.K. Akhmedova, A.S. Ametov, N.A. Chernikova, T.N. Korotkova
The aim: to improve the management of T2DM by using an influence of medicine from dipeptidyl peptidase-4 inhibitor group on lipid metabolism.
Material and methods. The study included 64 patients with T2DM and obesity (mean age 64.1 ± 9.03 years) who had not achieved target glycemic control levels with metformin monotherapy or dietary therapy. Group 1 received gosogliptin 30 mg/day with metformin 2000 mg/day. Group 2 received metformin 2000 mg/day as monotherapy. All participants had glycemic control at baseline and after 6 months. Changes in body weight, body mass index, waist and hip circumference, fasting plasma glucose, glycated hemoglobin (HbA1c), leptin, adiponectin, total cholesterol, triglycerides, low-density and high-density lipoprotein cholesterol, insulin, C-peptide, HOMA-IR and HOMA-B indexes were estimated during the study. Patients also underwent bioimpedance analysis.
Results. After 6 months, both groups showed positive changes in HbA1c and fasting plasma glucose levels. In Group 1, HbA1c level decreased from 7.91 ± 0.63% to 6.54 ± 0.66%, while in Group 2, it decreased from 7.07 ± 0.4% to 6.33 ± 0.49%. Leptin level decreased by 1.37 ng/ml in Group 1 and by 0.81 ng/ml in Group 2, while adiponectin level increased by 2.72 and 1.06 μg/ml, respectively. Participants in both groups showed positive dynamics in HOMA-IR, triglyceride/glucose (TG/Gl), and HOMA-B indexes. Statistically significant differences in anthropometric parameters were observed between the groups. According to bioimpedance analysis, Group 1 experienced a statistically significant decrease in absolute (by 4.09 kg) and relative (by 41.03%) fat mass, while in Group 2 these parameters decreased by 0.9 kg and 21.04%, respectively.
Conclusion. Combination therapy with dipeptidyl peptidase-4 inhibitor gosogliptin and metformin resulted in a reduction in glucose and lipotoxicity.
Keywords
lipid metabolism
gosogliptin
type 2 diabetes mellitus
metabolic regulation
insulin resistance
glycemic control
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About the Authors
Patimat K. Akhmedova, MD, postgraduate student of the Department of endocrinology, Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation.E-mail: patimat_akhmedova_96@inbox.ru
ORCID: https//orcid.org/0009-0006-4696-8932
Alexander S. Ametov, MD, Dr. Sci. (Medicine), professor, Honored Scientist of the Russian Federation, head of the Department of endocrinology, head of UNESCO network chair on “Bioethics of diabetes mellitus as a global problem”, Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation.
E-mail: alexander.ametov@gmail.com
ORCID: https//orcid.org/0000-0002-7936-7619
Natalia A. Chernikova, MD, PhD (Medicine), associate professor of the Department of endocrinology, Russian Medical Academy of Continuous Professional Education; head of the Department of endocrinology, Central Clinical Hospital of Civil Aviation, Moscow, Russian Federation.
E-mail: nachendoc@yandex.ru
ORCID: https://orcid.org/0000-0002-0562-8396
Tatiana N. Korotkova, MD, PhD (Medicine), head of the Department of clinical biochemistry, allergology, and immunology, Federal Research Center for Nutrition, Biotechnology, and Food Safety, Moscow, Russian Federation.
E-mail: tntisha@gmail.com
ORCID: https://orcid.org/0000-0002-3684-9992
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