Effects on Lipid Profile of Dipeptidyl Peptidase 4 Inhibitors, Pioglitazone, Acarbose, and Sulfonylureas: Meta-analysis of Placebo-Controlled Trials

Abstract

The present meta-analysis shows that available glucose-lowering drugs may have varying effects on the lipid profile. DPP-4 inhibitors, acarbose, and pioglitazone seem to have a more favorable effect on the lipid profile than sulfonylureas.

Low-dose glimepiride with sitagliptin improves glycemic control without dose-dependency in patients with type 2 diabetes inadequately controlled on high-dose glimepiride

“…Although previous studies have demonstrated that DPP-4 inhibitors might have a favorable effect on the lipid profile [17], the combination therapy with sitagliptin and glimepiride did not change level of LDL cholesterol or TG in this study.…”

Effect of Pioglitazone Versus Metformin on Cardiovascular Risk Markers in Type 2 Diabetes

“…The effect on total cholesterol is less clear but a recent meta-analysis reported that treatment with this drug was associated with a significant reduction in total cholesterol [35]. Furthermore, it is known that pioglitazone modifies LDL particle size, reducing its atherogenic effects [36].…”

Gut Peptides Are Novel Regulators of Intestinal Lipoprotein Secretion: Experimental and Pharmacological Manipulation of Lipoprotein Metabolism

“…Several recent meta-analyses indicated modest reductions in fasting LDL-C, total cholesterol, and TG with small or no significant improvement in HDL-C following chronic treatments with GLP-1R agonists (12)(13)(14) or DPP-4 inhibitors (13,15). For example, treatment with exenatide or liraglutide for several weeks to 3 years reduced fasting levels of TG, total cholesterol and LDL-C, increased HDL-C (16)(17)(18)(19); and reduced fasting apoB (19)(20)(21)(22), apoB-48 (a surrogate measure of intestinal lipoprotein particle numbers) (23), and free fatty acid (FFA) (24)(25)(26).…”