@article {Kitadae000391, author = {Munehiro Kitada and Shin-ichi Tsuda and Kazunori Konishi and Ai Takeda-Watanabe and Mizue Fujii and Keizo Kanasaki and Makoto Nishizawa and Atsushi Nakagawa and Daisuke Koya}, 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}, volume = {5}, number = {1}, elocation-id = {e000391}, year = {2017}, doi = {10.1136/bmjdrc-2017-000391}, publisher = {BMJ Specialist Journals}, 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\%{\textpm}1.2\% at 24 weeks compared with 7.3\%{\textpm}0.9\% at baseline. The levels of the log10-transformed UACR were significantly reduced from 1.95{\textpm}0.51 mg/g creatinine (Cr) at baseline to 1.76{\textpm}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 {\textmu}g/g Cr at baseline, was significantly decreased from baseline (8.5{\textpm}2.8 {\textmu}g/g Cr) to 24 weeks (3.1{\textpm}1.7 {\textmu}g/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.}, URL = {https://drc.bmj.com/content/5/1/e000391}, eprint = {https://drc.bmj.com/content/5/1/e000391.full.pdf}, journal = {BMJ Open Diabetes Research and Care} }