Effects of metformin and alogliptin on body composition in people with type 2 diabetes

• Published in: Journal of diabetes investigation Vol. 10; no. 3; pp. 723 - 730
• Main Authors: Takeshita, Yumie, Kita, Yuki, Kato, Ken‐ichiro, Kanamori, Takehiro, Misu, Hirofumi, Kaneko, Shuichi, Takamura, Toshinari
• Format: Journal Article
• Language: English
• Published: Japan John Wiley & Sons, Inc 01.05.2019; John Wiley and Sons Inc; Wiley
• Subjects: Adult; Aged; Aged, 80 and over; Antidiabetics; Biomarkers - analysis; Blood Glucose - analysis; Blood pressure; Body Composition; Body fat; Body mass index; Body weight; Clinical Trial; Clinical trials; Cross-Over Studies; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - drug therapy; Dipeptidyl peptidase‐4 inhibitors; Dipeptidyl-peptidase IV; Drug dosages; Drug Therapy, Combination; Female; Follow-Up Studies; Glucose; Glycated Hemoglobin A - analysis; Humans; Hypoglycemia; Hypoglycemic Agents - therapeutic use; Male; Metabolism; Metformin; Metformin - therapeutic use; Middle Aged; Overweight; Peptidase; Piperidines - therapeutic use; Pleiotropic effects; Prognosis; School dropout programs; School dropouts; Uracil - analogs & derivatives; Uracil - therapeutic use; Young Adult; Japan; Dipeptidyl peptidase-4 inhibitors; Pleiotropic effects; Metformin
• ISSN: 2040-1116; 2040-1124
• DOI: 10.1111/jdi.12920

Aims/Introduction The aim of the present study was to investigate the effects of metformin and a dipeptidyl peptidase‐4 inhibitor, alogliptin, on body composition in a 12‐week randomized add‐on trial in Japanese participants with type 2 diabetes. Materials and Methods A total of 84 participants with poorly controlled type 2 diabetes undergoing antidiabetic therapy were randomly assigned to receive alogliptin (25 mg, once daily) or metformin (1,000 mg, twice daily) for 12 weeks. The primary efficacy end‐point was body composition. The secondary end‐points included factors associated with decreased bodyweight. Results Compared with the baseline values, alogliptin significantly increased bodyweight (66.5 ± 19.2 to 67.6 ± 19.3 kg), body mass index (BMI; 25.4 ± 6.1 to 25.8 ± 6.3 kg/m2) and fat mass (20.3 ± 12.8 to 21.8 ± 14.5 kg), whereas metformin had no significant effect on body composition. Alogliptin was inferior to metformin in reducing bodyweight (0.84 ± 1.57 vs −0.35 ± 1.53 kg, P = 0.002), BMI (0.34 ± 0.69 to −0.15 ± 0.56 kg/m2, P = 0.002) and fat mass (1.49 ± 5.06 vs −0.04 ± 1.81 kg, P = 0.042). BMI at baseline was associated with changes in bodyweight negatively in the metformin group and positively in the alogliptin group. Conclusions Metformin and alogliptin exert opposite effects on bodyweight in type 2 diabetes patients who are overweight. The higher the BMI, the more metformin reduces bodyweight and alogliptin increases weight. The pleiotropic effects of DPP‐IV inhibitors and metformin have not been examined sufficiently. Our study is the first to investigate the pleiotropic effects of these drugs and identify clinical factors associated with reduced body weight and glucose levels after add‐on therapy. Compared with the baseline values, alogliptin significantly increased body weight, BMI, and fat mass, whereas metformin had no significant effect on body composition. Metformin and alogliptin exert opposite effects on body weight in type 2 diabetic patients with overweight. The higher the BMI, the more metformin reduces body weight and alogliptin increases weight.