Efficacy of alogliptin, a dipeptidyl peptidase-4 inhibitor, on glucose parameters, the activity of the advanced glycation end product (AGE) - receptor for AGE (RAGE) axis and albuminuria in Japanese type 2 diabetes.

BackgroundTo examine the effects of alogliptin, a dipeptidyl peptidase-4 inhibitor, on glucose parameters, the advanced glycation end product (AGE)-receptor for AGE (RAGE) axis and albuminuria in Japanese type 2 diabetes patients. MethodsSixty-one patients whose HbA(lc)6.1% (mean age 64.7years; 67% men; mean HbA(lc) 7.4%; 57% were pharmacologically treated) underwent blood and urine sampling and analysis before and after 12weeks of treatment with alogliptin (25mg once daily). ResultsAlogliptin treatment significantly reduced fasting glucose (160.3mg/dL at baseline versus 138.0mg/dL at 12weeks), glycoalbumin (21.1% at baseline versus 18.9% at 12weeks), HbAlc (7.4% at baseline versus 6.9% at 12weeks), circulating soluble form of RAGE concentrations (847.3pg/mL at baseline versus 791.4pg/mL at 12weeks) and urine albumin to creatinine ratio (31.6mg/g Cr at baseline versus 26.5mg/g Cr at 12weeks), whereas 1,5-anhydroglucitol concentrations were significantly increased (7.5 mu g/mL at baseline versus 11.6 mu g/mL at 12weeks; all P<0.05). Circulating AGEs concentrations were reduced only in patients with baseline AGEs 7U/mL (n=33, from 8.2U/mL to 7.2U/mL; p<0.01) after alogliptin treatment. The treatment-induced change of soluble form of sRAGE concentrations was associated with changes of 1,5-anhydroglucitol and HbA(lc) concentrations (rho=-0.32 and 0.29, respectively). Meanwhile, the treatment-induced change of urine albumin to creatinine ratio was associated with a change in the fasting glucose concentration (rho=0.25; all p<0.05). During the intervention, alogliptin treatment was well tolerated without any hypoglycemia or side effects. ConclusionAlogliptin treatment improved the AGE-RAGE axis and reduced albuminuria in Japanese type 2 diabetes patients. Copyright (c) 2013 John Wiley & Sons, Ltd.