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Dipeptidyl peptidase-4 inhibitors and bone metabolism: is vitamin D the link?

Abstract

Aims

Dipeptidyl peptidase-4 inhibitors (DPP4-Is) represent a promising class of agents for type 2 diabetes treatment. Experimental models and clinical studies have reported positive effects of DPP4-Is on bone; however, how DPP4-Is positively impact bone homeostasis in humans remains an unanswered question. Aim of this study investigated the relationship between treatment with DPP4-Is and vitamin D balance in patients with type 2 diabetes.

Methods

This is a cross-sectional study. A total of 295 consecutive individuals with type 2 diabetes referring to our diabetes outpatient clinics were enrolled; among them, 53 % were in treatment with DPP4-Is. Metabolic profile and routine biochemistry were assessed by standard methods; serum 25(OH) vitamin D levels [25(OH)D] were measured by colorimetric method (LAISON, DiaSorin).

Results

DPP4-Is-treated participants had significantly higher serum 25(OH)D levels then those undertaking other antidiabetic therapies (18.4 ± 10.7 vs. 14.9 ± 8.6 ng/ml, p = 0.004); this association persisted after adjusting for all major confounders. Increased 25(OH)D concentrations also correlated with the duration of DPP4-Is treatment and with a stronger DPP4 inhibitory activity.

Conclusions

DPP4-Is treatment is associated with improved vitamin D balance in people with type 2 diabetes; our findings suggest that vitamin D may underlie the link between DPP4-Is and bone metabolism.

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Corresponding author

Correspondence to M. G. Cavallo.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

This study has been reviewed by the Ethics Committee of Policlinico Umberto I, Sapienza University of Rome, and has therefore been performed according to the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki.

Human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Declaration of Helsinki 1975, as revised in 2008.

Informed consent

All persons gave their informed consent prior to their inclusion in the study; details that might disclose the identity of study participants have been omitted.

Additional information

Managed by Antonio Secchi.

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Cite this article

Barchetta, I., Cimini, F.A., Bloise, D. et al. Dipeptidyl peptidase-4 inhibitors and bone metabolism: is vitamin D the link?. Acta Diabetol 53, 839–844 (2016). https://doi.org/10.1007/s00592-016-0882-9

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Keywords

  • Dipeptidyl peptidase 4 inhibitors
  • Type 2 diabetes
  • Vitamin D
  • Therapy