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

• Published in: Acta diabetologica 2016-10, Vol.53 (5), p.839-844
• Main Authors: Barchetta, I., Cimini, F. A., Bloise, D., Cavallo, M. G.
• Format: Article
• Language: English
• Subjects: Aged; Bone and Bones - metabolism; Bone density; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Dipeptidyl-Peptidase IV Inhibitors - adverse effects; Dipeptidyl-Peptidase IV Inhibitors - therapeutic use; Female; Humans; Hypoglycemic Agents - adverse effects; Hypoglycemic Agents - therapeutic use; Inhibitor drugs; Internal Medicine; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Metabolism; Middle Aged; Original Article; Vitamin D; Vitamin D - blood
• ISSN: 0940-5429; 1432-5233
• DOI: 10.1007/s00592-016-0882-9

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.