Anagliptin ameliorates albuminuria and urinary liver-type fatty acid-binding protein excretion in patients with type 2 diabetes with nephropathy in a glucose-lowering-independent manner

Objective The objective of this study is to elucidate the effect of anagliptin on glucose/lipid metabolism and renoprotection in patients with type 2 diabetic nephropathy.Methods Twenty-five patients with type 2 diabetic nephropathy received anagliptin 200 mg/day for 24 weeks, and 20 patients who we...

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Main Authors: Daisuke Koya, Mizue Fujii, Munehiro Kitada, Shin-ichi Tsuda, Kazunori Konishi, Ai Takeda-Watanabe, Keizo Kanasaki, Makoto Nishizawa, Atsushi Nakagawa
Format: Article
Language:English
Published: BMJ Publishing Group 2017-07-01
Series:BMJ Open Diabetes Research & Care
Online Access:https://drc.bmj.com/content/5/1/e000391.full
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author Daisuke Koya
Mizue Fujii
Munehiro Kitada
Shin-ichi Tsuda
Kazunori Konishi
Ai Takeda-Watanabe
Keizo Kanasaki
Makoto Nishizawa
Atsushi Nakagawa
author_facet Daisuke Koya
Mizue Fujii
Munehiro Kitada
Shin-ichi Tsuda
Kazunori Konishi
Ai Takeda-Watanabe
Keizo Kanasaki
Makoto Nishizawa
Atsushi Nakagawa
author_sort Daisuke Koya
collection DOAJ
description Objective The objective of this study is to elucidate the effect of anagliptin on glucose/lipid metabolism and renoprotection in patients with type 2 diabetic nephropathy.Methods Twenty-five patients with type 2 diabetic nephropathy received anagliptin 200 mg/day for 24 weeks, and 20 patients who were switched to anagliptin from other dipeptidyl peptidase-4 (DPP-4) inhibitors were analyzed regarding primary and secondary endpoints. The primary endpoint was change in hemoglobin A1c (HbA1c) during treatment with anagliptin. Additionally, we evaluated changes in lipid data (low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol and triglyceride), blood pressure (BP), urinary albumin to creatinine ratio (UACR), liver-type fatty acid-binding protein to creatinine ratio (ULFABP) and renal function (estimated glomerular filtration rate and serum cystatin C) as secondary endpoints.Results After switching to anagliptin from other DPP-4 inhibitors, the levels of HbA1c in the 20 participants showed no significant change, 7.5%±1.2% at 24 weeks compared with 7.3%±0.9% at baseline. The levels of the log10-transformed UACR were significantly reduced from 1.95±0.51 mg/g creatinine (Cr) at baseline to 1.76±0.53 mg/g Cr at 24 weeks after anagliptin treatment (p<0.01). The percentage change in the UACR (Δ%UACR) from baseline to 24 weeks was also significantly lower by −10.6% (p<0.001). Lipid data, systolic BP and renal function were not changed during anagliptin treatment. Additionally, ULFABP in eight participants, who had ≥5 µg/g Cr at baseline, was significantly decreased from baseline (8.5±2.8 µg/g Cr) to 24 weeks (3.1±1.7 µg/g Cr, p<0.01) after anagliptin treatment, and the percentage change in the ULFABP during anagliptin treatment was −58.1% (p<0.001).Conclusions Anagliptin induced no significant change in HbA1c, lipid data, systolic BP and renal function. However, anagliptin reduced the UACR and ULFABP, although without a corresponding change in HbA1c, indicating direct action of anagliptin on renoprotection in patients with type 2 diabetic nephropathy.
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spelling doaj-art-c36c819b9c834110a059032e429d810f2025-08-20T03:08:59ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972017-07-015110.1136/bmjdrc-2017-000391Anagliptin ameliorates albuminuria and urinary liver-type fatty acid-binding protein excretion in patients with type 2 diabetes with nephropathy in a glucose-lowering-independent mannerDaisuke Koya0Mizue Fujii1Munehiro Kitada2Shin-ichi Tsuda3Kazunori Konishi4Ai Takeda-Watanabe5Keizo Kanasaki6Makoto Nishizawa7Atsushi Nakagawa81 Department of Diabetology and Endocrinology, Kanazawa Medical University, Ishikawa, Japan1 Department of Diabetology and Endocrinology, Kanazawa Medical University, Ishikawa, Japan1 Department of Diabetology and Endocrinology, Kanazawa Medical University, Ishikawa, Japan1 Department of Diabetology and Endocrinology, Kanazawa Medical University, Ishikawa, Japan1 Department of Diabetology and Endocrinology, Kanazawa Medical University, Ishikawa, Japan1 Department of Diabetology and Endocrinology, Kanazawa Medical University, Ishikawa, JapanDepartment of Internal Medicine 1, Faculty of Medicine, Shimane University, Shimane, Japan1 Department of Diabetology and Endocrinology, Kanazawa Medical University, Ishikawa, Japan1 Department of Diabetology and Endocrinology, Kanazawa Medical University, Ishikawa, JapanObjective The objective of this study is to elucidate the effect of anagliptin on glucose/lipid metabolism and renoprotection in patients with type 2 diabetic nephropathy.Methods Twenty-five patients with type 2 diabetic nephropathy received anagliptin 200 mg/day for 24 weeks, and 20 patients who were switched to anagliptin from other dipeptidyl peptidase-4 (DPP-4) inhibitors were analyzed regarding primary and secondary endpoints. The primary endpoint was change in hemoglobin A1c (HbA1c) during treatment with anagliptin. Additionally, we evaluated changes in lipid data (low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol and triglyceride), blood pressure (BP), urinary albumin to creatinine ratio (UACR), liver-type fatty acid-binding protein to creatinine ratio (ULFABP) and renal function (estimated glomerular filtration rate and serum cystatin C) as secondary endpoints.Results After switching to anagliptin from other DPP-4 inhibitors, the levels of HbA1c in the 20 participants showed no significant change, 7.5%±1.2% at 24 weeks compared with 7.3%±0.9% at baseline. The levels of the log10-transformed UACR were significantly reduced from 1.95±0.51 mg/g creatinine (Cr) at baseline to 1.76±0.53 mg/g Cr at 24 weeks after anagliptin treatment (p<0.01). The percentage change in the UACR (Δ%UACR) from baseline to 24 weeks was also significantly lower by −10.6% (p<0.001). Lipid data, systolic BP and renal function were not changed during anagliptin treatment. Additionally, ULFABP in eight participants, who had ≥5 µg/g Cr at baseline, was significantly decreased from baseline (8.5±2.8 µg/g Cr) to 24 weeks (3.1±1.7 µg/g Cr, p<0.01) after anagliptin treatment, and the percentage change in the ULFABP during anagliptin treatment was −58.1% (p<0.001).Conclusions Anagliptin induced no significant change in HbA1c, lipid data, systolic BP and renal function. However, anagliptin reduced the UACR and ULFABP, although without a corresponding change in HbA1c, indicating direct action of anagliptin on renoprotection in patients with type 2 diabetic nephropathy.https://drc.bmj.com/content/5/1/e000391.full
spellingShingle Daisuke Koya
Mizue Fujii
Munehiro Kitada
Shin-ichi Tsuda
Kazunori Konishi
Ai Takeda-Watanabe
Keizo Kanasaki
Makoto Nishizawa
Atsushi Nakagawa
Anagliptin ameliorates albuminuria and urinary liver-type fatty acid-binding protein excretion in patients with type 2 diabetes with nephropathy in a glucose-lowering-independent manner
BMJ Open Diabetes Research & Care
title Anagliptin ameliorates albuminuria and urinary liver-type fatty acid-binding protein excretion in patients with type 2 diabetes with nephropathy in a glucose-lowering-independent manner
title_full Anagliptin ameliorates albuminuria and urinary liver-type fatty acid-binding protein excretion in patients with type 2 diabetes with nephropathy in a glucose-lowering-independent manner
title_fullStr Anagliptin ameliorates albuminuria and urinary liver-type fatty acid-binding protein excretion in patients with type 2 diabetes with nephropathy in a glucose-lowering-independent manner
title_full_unstemmed Anagliptin ameliorates albuminuria and urinary liver-type fatty acid-binding protein excretion in patients with type 2 diabetes with nephropathy in a glucose-lowering-independent manner
title_short Anagliptin ameliorates albuminuria and urinary liver-type fatty acid-binding protein excretion in patients with type 2 diabetes with nephropathy in a glucose-lowering-independent manner
title_sort anagliptin ameliorates albuminuria and urinary liver type fatty acid binding protein excretion in patients with type 2 diabetes with nephropathy in a glucose lowering independent manner
url https://drc.bmj.com/content/5/1/e000391.full
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