Visual Abstract
Poor control of blood glucose could result in increase in advanced glycation end products (AGEs). AGEs cause various adverse vascular events such as atherosclerosis. Therefore, production of AGEs should be suppressed to prevent diabetic complications. In the present study, we evaluated effects of SGLT2 inhibitor (SGLT2i) and DPP-4 inhibitor (DPP-4i) on AGEs in patients with type 2 diabetes. The Japanese patients having poorly controlled blood glucose for 6 months were orally received SGLT2i (n=13; 2.5 mg/day luseogliflozin, 10 mg/day dapagliflozin, or 25 mg/day empagliflozin) or DPP-4i (n=11; 100 mg/day sitagliptin, 100 mg/day vildagliptin, or 25 mg/day alogliptin) for 3 months. Before and after the drug treatment, we measured HbA1c level and serum levels of lipids and hepatic function parameters. Besides, circulating methylglyoxal-derived hydroimidazolone-1 (MG-H1), one of AGEs, was determined optically. As shown in Table, SGLT2i significantly lowered HbA1c (P<0.05), MG-H1 (P<0.01), and serum γ-GTP (P<0.01), and elevated serum HDL-cholesterol (P<0.05). In contrast, DPP-4i little changed in MG-H1 and blood biochemical parameters except for reduction of HbA1c (P<0.05). Comparing DPP-4i, the present study demonstrates that SGLT2i has superiority on improvement of AGEs level in patients with type 2 diabetes while detailed mechanisms of this effect are not clear.
M. Kusunoki: Other Relationship; Self; Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd. N. Wakazono: None. F. Hisano: None. T. Miyata: None.
