Effect of sitagliptin therapy on postprandial lipoprotein levels in patients with type 2 diabetes
Diabetes, Obesity and Metabolism,  Clinical Article

Tremblay A J et al. - Treatment with sitagliptin for 6 weeks reduced postprandial plasma levels of atherogenic triglyceride (TG)-rich lipoproteins of both intestinal and hepatic origin, most likely by increasing incretin hormone levels, reducing circulating plasma free fatty acids (FFAs) concentrations and improving insulin sensitivity and beta-cell function.

Methods
  • This is a double-blind cross-over study.
  • 36 subjects with type 2 diabetes (30 men/6 postmenopausal women with a mean age of 58.1 ± 6.4 years and a body mass index of 30.7 ± 4.9 kg/m2) were considered.
  • Sitagliptin 100 mg/day or placebo for a 6-week period each was used, with a 4-week washout period between the two phases.
  • At the end of each phase of treatment, patients underwent an oral lipid tolerance test providing 35 g of fat per m2 of body surface area and blood samples were taken over an 8-h period.

Results
  • Sitagliptin therapy significantly decreased the postprandial area under the curves (AUCs) for plasma apolipoprotein (apo)B (-5.1%), apoB-48 (-7.8%), TG (-9.4%), very low-density lipoprotein (VLDL)-cholesterol (-9.3%), free fatty acids (FFAs) (-7.6%) and glucose (-9.7%).
  • The postprandial AUCs for plasma intact glucagon-like peptide-1 (+67.8%) and glucose-dependent insulinotropic polypeptide (+67.3%) were significantly increased following treatment with sitagliptin.
  • The AUC for plasma glucagon was reduced by -9.7% with no significant changes in the AUCs for plasma insulin and C-peptide.
  • Sitagliptin therapy also improved homeostasis model assessment (HOMA) index for insulin resistance (-14.6%) and beta-cell function (+32.3%).

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