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Meta-Analysis
. 2019 Jun 18;18(1):144.
doi: 10.1186/s12944-019-1086-4.

Effect of dipeptidyl-peptidase-4 inhibitors on C-reactive protein in patients with type 2 diabetes: a systematic review and meta-analysis

Xin Liu  1 , Peng Men  2 , Bo Wang  3 , Gaojun Cai  4 , Zhigang Zhao  5
Affiliations
Meta-Analysis

Effect of dipeptidyl-peptidase-4 inhibitors on C-reactive protein in patients with type 2 diabetes: a systematic review and meta-analysis

Xin Liu et al. Lipids Health Dis. .

Abstract

Background: Dipeptidyl peptidase-4 inhibitors (DPP-4i) are emerging glucose-lowering agents through interacting with DPP-4 substrate, impact of which on systemic inflammation in type 2 diabetes mellitus (T2DM) remains unknown. This study aimed to evaluate the effect of DPP-4i on modulating serum levels of C-reactive protein (CRP) in T2DM.

Methods: PubMed, Cochrane library and Embase databases were searched. Randomized controlled trials (RCTs) with comparators were selected. A random-effects model was used for quantitative data analysis. Heterogeneity was evaluated with I2 index. Sensitivity analysis was performed using the one-study remove approach.

Results: Sixteen trials with 1607 patients with T2DM were included. Pooled analysis of DPP-4i demonstrated a significant decrease in serum CRP concentrations (- 0.86 mg/L, 95% CI, - 1.36 to - 0.36). No significant difference was found between DPP-4i and active comparators on serum CRP concentrations (0.64 mg/L, 95% CI, - 0.10 to 1.37). Pooled analysis proved to be stable and credible by sensitivity analysis. In subgroup analysis, changes in serum concentrations of CRP were significantly associated with short diabetes duration (- 0.23 mg/L, 95% CI, - 0.41 to - 0.05).

Conclusions: DDP-4i effectively reduced serum CRP levels and showed no stronger effect than traditional oral antidiabetic agents. International Prospective Register for Systematic Review (PROSPERO) number: CRD42017076838.

Keywords: C-reactive protein; Dipeptidyl peptidase-4 inhibitors; Randomized controlled trials; Type 2 diabetes mellitus.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the number of studies identified and included into the meta-analysis
Fig. 2
Fig. 2
Forest plot for the impact of DDP-4i treatment versus placebo on CRP concentrations
Fig. 3
Fig. 3
Forest plot for the impact of DDP-4i treatment versus active comparator on CRP concentrations
Fig. 4
Fig. 4
Leave-one-out sensitivity analysis for the impact of DPP-4i on serum concentrations of CRP
Fig. 5
Fig. 5
Assessment of publication bias in the meta-analysis of studies reporting the impact of DPP-4i on serum concentrations of CRP
See this image and copyright information in PMC

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