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. 2017 Jul 25;8:487. doi: 10.3389/fphar.2017.00487

Figure 1.

Figure 1

Potential mechanisms of dipeptidyl peptidase-4 inhibitor (DPP-4I) on bone metabolism. (1) Different types of DPP-4Is affect bone metabolism differently. Sitagliptin have beneficial effects on bone resorption, bone mineral density, and bone quality, while vildagliptin shows no effect and saxagliptin negatively affects bone metabolism both in vivo and in vitro. (2) DPP-4Is attenuate the negative effects of hyperglycemia on the bone. (3) DPP-4Is affect bone cells and bone markers through DPP-4 substrates and DPP-4-related energy metabolism. (4) DPP-4 exerts inhibitory effects on bone metabolism through vitamin D-linked pathway. (5) Other possible pathways (MMP-9, matrix metallopeptidase-9; OC, osteoclast; BMD, bone mineral density; TRAP, tartrate-resistant acid phosphatase; ERK, extracellular signal-regulated kinase; GIP, gastric inhibitory polypeptide; GLP, glucagon-like peptide; SDF-1α, stromal cell-derived factor-1 alpha; NPY, neuropeptide Y; VitD, vitamin D; AT, adipose tissue; AGE, advanced glycation end products; p38 MAPK, p38 mitogen-activated protein kinase).