• Title/Summary/Keyword: Dipeptidyl peptidase-4 억제제

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Sitagliptin and Vildagliptin Use Evaluation among Dipeptidyl Peptidase 4 Inhibitors in Adult Koreans with Type 2 Diabetes Mellitus (한국인 제2형 당뇨병 환자에 대한 디펩티딜 펩티다제 4 억제제 중 Sitagliptin과 Vildagliptin의 약물 사용 평가)

  • Park, Hyun-Jung;Lee, Ok-Sang;Lim, Sung-Cil
    • YAKHAK HOEJI
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    • v.56 no.2
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    • pp.136-143
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    • 2012
  • Type 2 Diabetes Mellitus (T2DM) is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency. Diabetes is often initially managed by increasing exercise and dietary modification. As the condition progresses, medications may be needed such as oral sulfonylurea or others. Recently, dipeptidyl peptidase 4 (DPP- 4) Inhibitor is new drug which can control blood glucose by increasing the active levels of incretin hormone in the body. However, researches have been carried out for mostly Caucasian and Japanese, not for Koreans at all. Therefore, this study was to evaluate the efficacy and safety of DPP-4 inhibitor (Sitagliptin, Vildagliptin) in patients with T2DM in Koreans. This study was carried out retrospectively with reviewing of medical records from the 141 patients who received sitagliptin or vildagliptin over 24 week periods from January 2009, to December 2009. Information including demographics, concomitant medication, disease duration, and exercise was evaluated. $HbA_{1c}$, random blood glucose, post prandial 2 hour glucose, blood pressure, AST, ALT, serum creatinine, total cholesterol, triglyceride levels were also collected at baseline and endpoint (at 24 weeks). In each post-treatment group, $HbA_{1c}$, random blood glucose and post prandial 2 hour glucose levels were decreased significantly from baseline in the sitagliptin group (-0.82%, -28.76 mg/dl, -46.65 mg/dl) and vildagliptin group(-1.22%, -27.96 mg/dl, -67.2 mg/dl). Greater $HbA_{1c}$ mean reductions from baseline to 24 weeks were seen in patients with higher baseline values (>7.0%), with shorter disease durations (${\leq}1$ year) compared with those with lower baseline values (<7.0%), with longer disease durations (>1 year) in both sitagliptin and vildagliptin groups. The incidences of hypoglycemia, headache and upper respiratory infection were 0%, 8.7%, 5.8% in sitagliptin group and 2.8%, 8.3%, 6.9% in vildagliptin group. In conclusion, our results showed DPP-4 inhibitor provided similar efficacy compared with sulfonylurea after 24 weeks of treatment and were safer than sulfonylurea in hypoglycemia for Korean T2DM. Also vildagliptin was associated with significant improvement in $HbA_{1c}$ reduction in Korean patient with subgroup (body mass index<25 $kg/m^2$, metformin dose${\geq}$1000 mg, p<0.05) compared to sitagliptin. Therefore, even though DPP-4 inhibitor use for Korean needs to be studied more consistently in the future, DPP-4 inhibitor is a safe and effective drug for Korean T2DM based on our result.

Anti-diabetic peptides derived from milk proteins (우유단백질 유래 혈당 조절 기능성 펩타이드)

  • Kim, Seonyoung;Imm, Jee-Young
    • Food Science and Industry
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    • v.51 no.4
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    • pp.302-312
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    • 2018
  • Bioactive peptides generated from milk proteins play an important role in the prevention and alleviation of diabetes. Whey proteins possess direct insulinotropic effect by amino acids (especially branch chain amino acids) produced through its gastrointestinal digestion. Additionally, blood glucose level can be lowered by gut hormone which called incretin [glucose dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1)]. However, physiological effects of incretin readily disappeared by dipeptidyl peptidase-4 (DPP-4) causing degradation of GLP-1. Several DPP-4 inhibitors are currently used as therapeutic medicines for the treatment of type II diabetes. More than 60 natural peptide (2-14 amino acids) DPP-4 inhibitors were identified in milk proteins. Peptide DPP-4 inhibitors act as substrate inhibitor and delay breakdown of GLP-1 both in vitro and in vivo. This review summarizes nutritional quality of milk proteins, absorption and mode of action of bioactive peptides, and finally up-to-dated knowledge on DPP-4 inhibitory peptides derived from milk proteins.

Caulerpa okamurae ethanol extract improves the glucose metabolism and insulin sensitivity in vitro and in vivo (옥덩굴 에탄올 추출물의 당 대사 및 인슐린 민감성 개선효과)

  • Park, Chul-Min;Thakuri, Laxmi Sen;Rhyu, Dong-Young
    • Journal of Applied Biological Chemistry
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    • v.64 no.1
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    • pp.89-96
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    • 2021
  • The aim of this study is to examine the effect of Caulerpa okamurae ethanol extract (COE) on glucose metabolism and insulin sensitivity as one of the drug targets for treatment of type2 diabetes. COE significantly inhibited protein tyrosine phosphatase (PTP1B) and dipeptidyl peptidase-IV (DPP-IV) enzyme activities in vitro assay. Also, COE significantly enhanced the glucose uptake and the expression of insulin receptor substrate-1 (IRS-1) and glucose transporter4 (GLUT4) proteins in 3T3-L1 adipocytes or zebrafish larvae compared with control. In dexamethasone-induced resistance model of L6 myotubes, the protein expression of insulin signaling and glucose uptake was effectively increased by the treatment of COE. In contrast, the elevated phosphorylation of IRS-1 Ser307 was normally suppressed by treatment of COE. However, COE had no effect on insulin secretion in pancreatic beta cells. Thus, our results suggest that COE improves the glucose metabolism and insulin sensitivity through the regulation of insulin signaling and GLUT4 protein in insulin's target cells and zebrafish larvae.