Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2020; 8(10): 1878-1886
Published online May 26, 2020. doi: 10.12998/wjcc.v8.i10.1878
Ligliptin for treatment of type 2 diabetes mellitus with early renal injury: Efficacy and impact on endogenous hydrogen sulfide and endothelial function
Jian Zhang, Yong-Li Du, Hui Zhang, Hong Sui, Wei-Kai Hou
Jian Zhang, Wei-Kai Hou, Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
Jian Zhang, Department of Endocrinology, Central Hospital of Tai’an City, Tai’an 271000, Shandong Province, China
Yong-Li Du, Department of Pharmacy, Tai'an Central Hospital, Tai'an 271000, Shandong Province, China
Hui Zhang, Department of Rheumatology, Tai'an Central Hospital, Tai'an 271000, Shandong Province, China
Hong Sui, Department of Geriatrics, Tai'an Central Hospital, Tai'an 271000, Shandong Province, China
Author contributions: Zhang J and Du YL analyzed and interpreted the data and wrote the article; Zhang H, Sui H, and Hou WK drafted the manuscript and collected the data; Hou WK designed the study and revised the article for important intellectual content.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Central Hospital of Tai’an City.
Informed consent statement: The patients gave informed consent to the study.
Conflict-of-interest statement: All authors declare no conflicts of interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Wei-Kai Hou, PhD, Professor, Department of Endocrinology, Qilu Hospital of Shandong University, 107 Wenhua West Road, Lixia District, Jinan 250012, Shandong Province, China. pro.hwk@163.com
Received: January 20, 2020
Peer-review started: January 20, 2020
First decision: March 18, 2020
Revised: March 19, 2020
Accepted: April 15, 2020
Article in press: April 15, 2020
Published online: May 26, 2020
Processing time: 125 Days and 23.3 Hours
Abstract
BACKGROUND

Diabetes is a clinically common chronic disease, and its incidence has been increasing in recent years. Diabetes is believed to accelerate the process of atherosclerosis in patients, and abnormal endothelial function is an important factor leading to diabetic kidney damage.

AIM

To investigate the efficacy of ligliptin in the treatment of type 2 diabetes mellitus (T2DM) with early renal injury and its effect on serum endogenous hydrogen sulfide (H2S), endothelial cell particles, and endothelial function.

METHODS

From January 2018 to April 2019, 110 patients with T2DM and early kidney injury treated at our hospital were divided into an observation group (receiving ligliptin treatment, n = 54) and a control group (receiving gliquidone therapy, n = 56). Blood glucose and renal function before and after treatment were compared between the two groups.

RESULTS

The differences in fasting blood glucose, 2 h blood glucose, and glycated hemoglobin were not statistically significant between the two groups after treatment. The urinary albumin excretion rate after treatment in the ligliptin group was 70.32 ± 11.21 µg/min, which was significantly lower than that of the gliquidone group (P = 0.000). Serum endogenous H2S and endothelial cell microparticles of the ligliptin treatment group were 40.04 ± 8.82 mol/L and 133.40 ± 34.39, respectively, which were significantly lower than those of the gliquidone treatment group (P = 0.000 for both); endothelin-dependent diastolic function and nitric oxide after treatment in the ligliptin group were 7.98% ± 1.22% and 190.78 ± 30.32 mol/L, significantly higher than those of the gliquidone treatment group (P = 0.000 for both).

CONCLUSION

Ligliptin treatment of T2DM with early renal injury has the same glucose-lowering effect as gliquidone treatment. Ligliptin treatment has a better effect and it can significantly improve the renal function and vascular endothelial function of patients, and reduce serum endogenous H2S and endothelial cell particle levels.

Keywords: Ligliptin; Type 2 diabetes; Early renal injury; Serum endogenous hydrogen sulfide; Endothelial cell granules; Endothelial function

Core tip: At present, diabetes is believed to accelerate the process of atherosclerosis in patients, and abnormal endothelial function is an important factor leading to diabetic kidney damage. The dipeptidyl peptidase 4 inhibitor ligliptin belongs to intestinal insulinotropic drugs, which can effectively reduce blood sugar. In order to further confirm the effect and specific mechanism of ligliptin application in patients with type 2 diabetes with kidney injury, this study compared the effects of ligliptin and gliquidone in this population.