Overproduction of intestinally derived triglyceride-rich lipoproteins (TRLs) (chylomicrons)
has recently been described in type 2 diabetes (T2DM), as is known for hepaticTRL
(very-low-density lipoprotein) production.
There is an interest in identifying therapies that would favourably influence postprandial
concentrations of lipids in T2DM.
linagliptin is a potent and selective inhibitor of dipeptidyl peptidase IV (DPP-IV), and has
been shown to reduce fasting and postprandial glucose levels in patients with type 2 diabetes
mainly through incretin hormone-mediated improvements in islet function.
Although clinical studies to date indicate that fasting lipid levels are minimally affected
by DPP-IV inhibitor treatment, animal studies suggested that DPP-IV inhibition reduce
intestinal triglycerides (TG) absorption and apolipoprotein (apo) production and increased
chylomicron catabolism. Interestingly, a recent study supporting this hypothesis showed that
vildagliptin therapy was able to reduce postprandial intestinal TRL particles in patients
with type 2 diabetes. Recently, it had reported that sitagliptin treatment significantly
reduced plasma apoB-48 and TG concentrations in the postprandial state.
The action of DPP-IV inhibitors may be explained by insulin secretion or action of
glucagon-like peptide (GLP-1) on metabolism of TRL.
Therefore, the present study was designed to examine the effects of linagliptin treatment
(LT) vs standard treatment (ST) on the metabolism of TRL apoB-48 in patients with type 2
diabetes over a 12 weeks-period.
The investigators will study the patients in three different moments defined as: Time 0 (2
weeks before LT or ST, Time 1 (4 weeks after LT or ST), Time 2 (12 weeks after LT or ST).
With areas under the curve (AUCs) of apoB48 in postprandial conditions.