Hemoglobin glycation index as a useful predictor of therapeutic responses to dipeptidyl peptidase-4 inhibitors in patients with type 2 diabetes

• Published in: PloS one Vol. 12; no. 2; p. e0171753
• Main Authors: Chen, Yu-Wei, Wang, Jun-Sing, Sheu, Wayne H-H, Lin, Shih-Yi, Lee, I-Te, Song, Yuh-Min, Fu, Chia-Po, Lee, Chia-Lin
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 09.02.2017; Public Library of Science (PLoS)
• Subjects: Adamantane - analogs & derivatives; Adamantane - therapeutic use; Adult; Aged; Analysis; Biology and life sciences; Biomarkers, Pharmacological - blood; Blood Glucose - drug effects; Care and treatment; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - drug therapy; Dipeptides - therapeutic use; Dipeptidyl-peptidase IV; Dipeptidyl-Peptidase IV Inhibitors - therapeutic use; Endocrinology; Fasting; Female; Glucose; Glycated Hemoglobin - analysis; Glycated Hemoglobin - metabolism; Glycemic index; Glycosylated hemoglobin; Glycosylation; Health aspects; Health Status Indicators; Hemoglobin; Hospitals; Humans; Inflammation; Inhibitors; Internal medicine; Linagliptin - therapeutic use; Male; Medicine; Medicine and health sciences; Metabolism; Middle Aged; Nitriles - therapeutic use; Patients; Peptidase; Physical Sciences; Predictive Value of Tests; Prognosis; Public health; Pyrrolidines - therapeutic use; Retrospective Studies; Risk factors; Sitagliptin Phosphate - therapeutic use; Systematic review; Treatment Outcome; Type 2 diabetes; Vildagliptin; Japan; Taiwan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0171753

A high hemoglobin glycation index (HGI) and glycated hemoglobin (HbA1c) level are associated with greater inflammatory status, and dipeptidyl peptidase-4 (DPP-4) inhibitors can suppress inflammation. We aimed to evaluate the relationship between HGI and the therapeutic effect of DPP-4 inhibitors. This retrospective cohort study followed 468 patients with type 2 diabetes receiving DPP-4 inhibitor treatment for 1 year. Estimated HbA1c was calculated using a linear regression equation derived from another 2969 randomly extracted patients with type 2 diabetes based on fasting plasma glucose (FPG) level. The subjects were divided into two groups based on HGI (HGI = observed HbA1c - estimated HbA1c). Mixed model repeated measures were used to compare the treatment efficacy after 1 year in patients with a low (HGI<0, n = 199) and high HGI (HGI≧0, n = 269). There were no significant group differences in mean changes of FPG after 1 year (-12.8 and -13.4 mg/dL in the low and high HGI groups, respectively). However, the patients with a high HGI had a significantly greater reduction in HbA1c from baseline compared to those with a low HGI (-1.9 versus -0.3% [-20.8 versus -3.3 mmol/mol]). Improvements in glycemic control were statistically significantly associated with the tested DPP-4 inhibitors in the high HGI group (-2.4, -1.4, -1.2 and -2.2% [-26.2, -15.3, -13.1 and -24.0 mmol/mol] for vildagliptin, linagliptin, saxagliptin and sitagliptin, respectively) but not in the low HGI group. The HGI index derived from FPG and HbA1c may be able to identify who will have a better response to DPP-4 inhibitors.