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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
  1. Munehiro Kitada1,2,
  2. Shin-ichi Tsuda1,
  3. Kazunori Konishi1,
  4. Ai Takeda-Watanabe1,
  5. Mizue Fujii1,
  6. Keizo Kanasaki1,2,
  7. Makoto Nishizawa1,
  8. Atsushi Nakagawa1,
  9. Daisuke Koya1,2
  1. 1 Department of Diabetology and Endocrinology, Kanazawa Medical University, Ishikawa, Japan
  2. 2 Division of Anticipatory Molecular Food Science and Technology, Medical Research Institute, Kanazawa Medical University, Uchinada, Ishikawa, Japan
  1. Correspondence to Dr Munehiro Kitada; kitta{at}kanazawa-med.ac.jp

Abstract

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.

  • type 2 diabetes
  • nephropathy
  • anti-diabetic drugs
  • albuminuria

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

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Footnotes

  • Contributors MK and DK designed the study, researched and analyzed the data and wrote and edited the manuscript. KK, ST, MF, MN and AN contributed to the research and the collection of data. KK contributed to the discussion. DK is the guarantor of this work.

  • Funding This work was financially supported by a grant from the Kidney Foundation, Japan and SANWA KAGAKU KENKYUSHO CO,LTD to DK.

  • Competing interests Boehringer Ingelheim, Mitsubishi Tanabe Pharma, Kyowa Hakko Kirin, Taisho Toyama Pharmaceutical and Ono Pharmaceutical contributed to establishing the Division of Anticipatory Molecular Food Science and Technology. The authors declare that there are no conflicts of interest associated with this manuscript.

  • Patient consent Obtained.

  • Ethics approval Kanazawa Medical University.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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