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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 BMJ+Open+Diabetes+Res+Care
2018 ; 6
(1
): e000469
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gab.com Text
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English Wikipedia
Ursodeoxycholic acid potentiates dipeptidyl peptidase-4 inhibitor sitagliptin by
enhancing glucagon-like peptide-1 secretion in patients with type 2 diabetes and
chronic liver disease: a pilot randomized controlled and add-on study
#MMPMID29607050
Shima KR
; Ota T
; Kato KI
; Takeshita Y
; Misu H
; Kaneko S
; Takamura T
BMJ Open Diabetes Res Care
2018[]; 6
(1
): e000469
PMID29607050
show ga
OBJECTIVE: We evaluated the effects of ursodeoxycholic acid (UDCA) on
glucagon-like peptide-1 (GLP-1) secretion and glucose tolerance in patients with
type 2 diabetes with chronic liver disease. RESEARCH DESIGN AND METHODS: Japanese
patients with type 2 diabetes (glycated hemoglobin (HbA1c) levels ?7.0%) and
chronic liver disease were included in this study. Sixteen patients (HbA1c level,
7.2%±0.6%(55.2 mmol/mol)) were randomized to receive 900?mg UDCA for 12 weeks
followed by 50?mg sitagliptin add-on therapy for 12 weeks (UDCA-first group; n=8)
or 50?mg sitagliptin for 12 weeks followed by 900?mg UDCA add-on therapy for 12
weeks (sitagliptin-first group; n=8). All patients underwent a liquid high-fat
meal test before and after 12 or 24 weeks of treatment. RESULTS: The baseline
characteristics were similar between the UDCA-first and sitagliptin-first groups.
There was a decrease in body weight (72.5±8.4?to 70.6±8.6?kg; P=0.04) and the
HbA1c level (7.0%±0.3%?to 6.4%±0.5%(53.0 to 46.4?mmol/mol); P=0.01) in the
UDCA-first group. The HbA1c level decreased further after sitagliptin
administration (6.4%±0.5%?to 6.0%±0.4%(46.4 to 42.1?mmol/mol); P<0.01). Although
there were no initial changes in the weight and HbA1c level in the
sitagliptin-first group, the HbA1c level decreased after UDCA addition
(7.1%±1.1%?to 6.6%±0.9%(54.1 to 48.6?mmol/mol); P=0.04). UDCA alone increased the
area under the curve(0-30) for GLP-1 response (115.4±47.2?to
221.9±48.9?pmol·min/L; P<0.01), but not the glucose-dependent insulinotropic
polypeptide response, in the UDCA-first group. CONCLUSIONS: UDCA treatment
resulted in a greater reduction in HbA1c levels, and an increased early phase
GLP-1 secretion. TRIAL REGISTRATION NUMBER: NCT01337440.