Effect of alogliptin on albuminuria in patients with early type 2 diabetic nephropathy and related mechanism

Objective To investigate the effect of alogliptin on albuminuria in patients with early type 2 diabetic kidney disease (DKD) and the related mechanism. Methods One hundred patients with early DKD admitted in our hospital from May 2016 to May 2017 were randomly divided into two groups with 50 cases in each group. Patients in the control group were given metformin and gliclazide, while those in study group were given metformin and alogliptin, the treatment lasted for 24 weeks. The changes of urinary albumin-to-creatinine ratio (UACR), stromal cell-derived factor-1α (SDF-1α) and the fasting plasma glucose (FPG), 2-h postprandial plasma glucose (2 hPPG), glycosylated hemoglobin(HbA1c) were measured before and after the treatment in two groups. Results There were no significant differences in HbA1c [(8.17±0.46)% vs. (8.29±0.48)%], UACR[(109±53) vs. (105±48)mg/g], SDF-1α [(1.21±0.3 9) vs. (1.17±0.35)μg/L] levels before treatment between two groups (t=0.343, 0.464, 0.075, all P>0.05). After treatment, the HbA1c levels were significantly decreased in both groups (t=2.293, 2.302, all P=0.03) and there was no significant difference between two groups[(6.82±0.75)% vs. (6.93±0.79)%, t=0.295, P=0.77]; the UACR levels were significantly reduced in both groups, but the level of study group was significantly lower than that of control group [(82±38) vs.(94±47) mg/g, t=3.320, P 0.05]. Conclusion Alogliptin can effectively control the blood glucose, reduce urine albumin excretion and protect renal function in patients with early type 2 diabetic nephropathy, which is associated with the increased SDF-1α levels. Key words: Diabetic nephropathies; Dipeptidyl-peptidase Ⅳ inhibitors; Urinary albumin- to-creatinineratio; Albuminuria; Stromal cell-derived factor-1α