Published in:
01-09-2006 | Article
Vildagliptin therapy reduces postprandial intestinal triglyceride-rich lipoprotein particles in patients with type 2 diabetes
Published in: Diabetologia | Issue 9/2006
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Aims/hypothesis
We assessed the effects of vildagliptin, a novel dipeptidyl peptidase IV inhibitor, on postprandial lipid and lipoprotein metabolism in patients with type 2 diabetes.
Subjects, materials and methods
This was a single-centre, randomised, double-blind study in drug-naive patients with type 2 diabetes. Patients received vildagliptin (50 mg twice daily, n=15) or placebo (n=16) for 4 weeks. Triglyceride, cholesterol, lipoprotein, glucose, insulin, glucagon and glucagon-like peptide-1 (GLP-1) responses to a fat-rich mixed meal were determined for 8 h postprandially before and after 4 weeks of treatment.
Results
Relative to placebo, 4 weeks of treatment with vildagliptin decreased the AUC0–8h for total trigyceride by 22±11% (p=0.037), the incremental AUC0–8h (IAUC0–8h) for total triglyceride by 85±47% (p=0.065), the AUC0–8h for chylomicron triglyceride by 65±19% (p=0.001) and the IAUC0–8h for chylomicron triglyceride by 91±28% (p=0.002). This was associated with a decrease in chylomicron apolipoprotein B-48 (AUC0–8h, −1.0±0.5 mg l−1 h, p=0.037) and chylomicron cholesterol (AUC0–8h, −0.14±0.07 mmol l−1 h, p=0.046). Consistent with previous studies, 4 weeks of treatment with vildagliptin also increased intact GLP-1, suppressed inappropriate glucagon secretion, decreased fasting and postprandial glucose, and decreased HbA1c from a baseline of 6.7% (change, −0.4±0.1%, p<0.001), all relative to placebo.
Conclusions/interpretation
Treatment with vildagliptin for 4 weeks improves postprandial plasma triglyceride and apolipoprotein B-48-containing triglyceride-rich lipoprotein particle metabolism after a fat-rich meal. The mechanisms underlying the effects of this dipeptidyl peptidase IV inhibitor on postprandial lipid metabolism remain to be explored.