Effect of Dipeptidyl Peptidase-4 Inhibitors on Bone Health in Patients with Type 2 Diabetes Mellitus

Lee, Dong Hwa; Kim, Kyong Young; Yoo, Min Young; Moon, Hyeong Cheol; Ku, Eu Jeong; Oh, Tae Keun; Jeon, Hyun Jeong

doi:10.3390/jcm10204775

Cited by 6 publications

(6 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Clinical studies in patients treated with DPP-4i showed both neutral and positive effects on BMD and BMTs by this class of drug [74][75][76]. A retrospective analysis of 200 patients with T2DM reported a similar BMD increase after 12 months in the DPP-4i and in the control group (treated with other classes of antidiabetics), and a trend toward a higher TBS value in the DPP-4i group [76].…”

Section: Clinical Studiesmentioning

confidence: 93%

Effect of Antidiabetic Drugs on Bone Health in Patients with Normal Renal Function and in Chronic Kidney Disease (CKD): Insight into Clinical Challenges in the Treatment of Type 2 Diabetes

Cipriani,

Lauriero,

Tripepi

et al. 2023

JCM

View full text Add to dashboard Cite

Among the metabolic changes occurring during the course of type 2 diabetes (T2DM) and diabetic kidney disease (DKD), impaired bone health with consequent increased fracture risk is one of the most complex and multifactorial complications. In subjects with diabetic kidney disease, skeletal abnormalities may develop as a consequence of both conditions. In the attempt to define a holistic approach to diabetes, potential effects of various classes of antidiabetic drugs on the skeleton should be considered in the setting of normal kidney function and in DKD. We reviewed the main evidence on these specific topics. Experimental studies reported potential beneficial and harmful effects on bone by different antidiabetics, with few data available in DKD. Clinical studies specifically designed to evaluate skeletal effects of antidiabetics have not been performed; notwithstanding, data gleaned from randomized controlled trials and intervention studies did not completely confirm observations made by basic research. In the aggregate, evidence from meta-analyses of these studies suggests potential positive effects on fracture risk by metformin and glucagon-like peptide-1 receptor agonists, neutral effects by dipeptidyl peptidase-4 inhibitors, sodium–glucose cotransporter-2 inhibitors, and sulfonylureas, and negative effects by insulin and thiazolidinediones. As no clinical recommendations on the management of antidiabetic drugs currently include fracture risk assessment among the main goal of therapy, we propose an integrated approach with the aim of defining a patient-centered management of diabetes in chronic kidney disease (CKD) and non-CKD patients. Future clinical evidence on the skeletal effects of antidiabetics will help in optimizing the approach to a personalized and more effective therapy of diabetes.

show abstract

Section: Clinical Studiesmentioning

confidence: 93%

Effect of Antidiabetic Drugs on Bone Health in Patients with Normal Renal Function and in Chronic Kidney Disease (CKD): Insight into Clinical Challenges in the Treatment of Type 2 Diabetes

Cipriani,

Lauriero,

Tripepi

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“… 129 However, unsurprisingly it has been demonstrated that DPP-4 inhibitors can lower the risk of bone fracture. 130 Sitagliptin, a potent and selective DPP-4 inhibitor, has been shown to elevate BMD and bone quality in mice. 130 Further investigation of the effect of sitagliptin on bone quality in diabetic rodents reveals promotion of cortical bone volume, trabecular architecture and overall bone strength.…”

Section: The Gastrointestinal Tract and Bonementioning

confidence: 99%

“… 130 Sitagliptin, a potent and selective DPP-4 inhibitor, has been shown to elevate BMD and bone quality in mice. 130 Further investigation of the effect of sitagliptin on bone quality in diabetic rodents reveals promotion of cortical bone volume, trabecular architecture and overall bone strength. 131 - 133 In high fat fed mice, once daily administration of sitagliptin for 3 weeks positively modified bone composition and improved overall bone strength and resistance to fracture.…”

Section: The Gastrointestinal Tract and Bonementioning

confidence: 99%

See 1 more Smart Citation

Gut-Derived Peptide Hormone Analogues and Potential Treatment of Bone Disorders in Obesity and Diabetes Mellitus

Ali,

Flatt,

Irwin

2024

Clin Med Insights Endocrinol Diabetes

View full text Add to dashboard Cite

Obesity and diabetes mellitus are prevalent metabolic disorders that have a detrimental impact on overall health. In this regard, there is now a clear link between these metabolic disorders and compromised bone health. Interestingly, both obesity and diabetes lead to elevated risk of bone fracture which is independent of effects on bone mineral density (BMD). In this regard, gastrointestinal (GIT)-derived peptide hormones and their related long-acting analogues, some of which are already clinically approved for diabetes and/or obesity, also seem to possess positive effects on bone remodelling and microarchitecture to reduce bone fracture risk. Specifically, the incretin peptides, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), as well as glucagon-like peptide-2 (GLP-2), exert key direct and/or indirect benefits on bone metabolism. This review aims to provide an initial appraisal of the relationship between obesity, diabetes and bone, with a focus on the positive impact of these GIT-derived peptide hormones for bone health in obesity/diabetes. Brief discussion of related peptides such as parathyroid hormone, leptin, calcitonin and growth hormone is also included. Taken together, drugs engineered to promote GIP, GLP-1 and GLP-2 receptor signalling may have potential to offer therapeutic promise for improving bone health in obesity and diabetes.

show abstract

“…Trabecular Bone Score (TBS) and BMD in DPP‐4i users was estimated by a retrospective study with T2D. ( 91 ) They found that exposed to DPP‐4is had a higher TBS which is an index of bone microarchitecture. However, the BMD increased in both DPP‐4 exposed and unexposed groups, with no significant differences between the groups.…”

Section: Effects Of Incretins On Bone Healthmentioning

confidence: 99%

Effects of Incretin Therapy on Skeletal Health in Type 2 Diabetes—A Systematic Review

Viggers,

Rasmussen,

Vestergaard

2023

JBMR Plus

View full text Add to dashboard Cite

Diabetes poses a significant risk to bone health, with Type 1 diabetes (T1D) having a more detrimental impact than Type 2 diabetes (T2D). The group of hormones known as incretins, which includes gastric inhibitory peptide (GIP) and glucagon‐like peptide 1 (GLP‐1), play a role in regulating bowel function and insulin secretion during feeding. GLP‐1 receptor agonists (GLP‐1 RAs) are emerging as the primary treatment choice in T2D, particularly when atherosclerotic cardiovascular disease is present. Dipeptidyl peptidase 4 inhibitors (DPP‐4is), although less potent than GLP‐1 RAs, can also be used. Additionally, GLP‐1 RAs, either alone or in combination with GIP, may be employed to address overweight and obesity. Since feeding influences bone turnover, a relationship has been established between incretins and bone health. To explore this relationship, we conducted a systematic literature review following the PRISMA guidelines. While some studies on cells and animals have suggested positive effects of incretins on bone cells, turnover, and bone density, human studies have yielded either no or limited and conflicting results regarding their impact on bone mineral density (BMD) and fracture risk. The effect on fracture risk may vary depending on the choice of comparison drug and the duration of follow‐up, which was often limited in several studies. Nevertheless, GLP‐1 RAs may hold promise for people with T2D who have multiple fracture risk factors and poor metabolic control. Furthermore, a potential new area of interest is the use of GLP‐1 RAs in fracture prevention among overweight and obese people. Based on this systematic review, existing evidence remains insufficient to support a positive or a superior effect on bone health to reduce fracture risk in people with T2D. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

show abstract

Effect of Dipeptidyl Peptidase-4 Inhibitors on Bone Health in Patients with Type 2 Diabetes Mellitus

Cited by 6 publications

References 28 publications

Effect of Antidiabetic Drugs on Bone Health in Patients with Normal Renal Function and in Chronic Kidney Disease (CKD): Insight into Clinical Challenges in the Treatment of Type 2 Diabetes

Effect of Antidiabetic Drugs on Bone Health in Patients with Normal Renal Function and in Chronic Kidney Disease (CKD): Insight into Clinical Challenges in the Treatment of Type 2 Diabetes

Gut-Derived Peptide Hormone Analogues and Potential Treatment of Bone Disorders in Obesity and Diabetes Mellitus

Effects of Incretin Therapy on Skeletal Health in Type 2 Diabetes—A Systematic Review

Contact Info

Product

Resources

About