Table 5.

Summary of clinical studies on dipeptidyl peptidase-4 inhibitors in metabolic syndrome

Effects	Study design	Results	Ref.
Anti-hyperlipidemia/atherosclerosis/obesity	Patients with diabetes and chronic kidney disease undergoing hemodialysis, teneligliptin 20 mg/day for 12 weeks	↓ hemoglobin A1c (HbA1c) ↓ fasting plasma glucose (FPG) and remnant-like particle cholesterol	[93]
	Patients with type 2 diabetes mellitus (T2DM) gemigliptin 50 mg/day, at the end, subjects underwent a high-fat meal tolerance test	↓ fasting and post prandial glucose levels ↓ fasting and post prandial triglyceride (TG) levels ↓ fasting, peak and total area under curve levels of ApoB48	[95]
	patients with T2DM sitagliptin 100 mg/day for 6 weeks	↓ plasma triglyceride ↓ apoB-48 ↓ free fatty acid concentrations ↓ HbA1c ↓ plasma glucose levels ↓ production rate and pool size of triglyceride-rich lipoprotein apoB-48 ↓ pool size of VLDL apoB-100	[97]
	T2DM patients sitagliptin 25–100 mg/day for 12 months	After 3 months: ↓ HbA1c ↓ pentraxin-3 level ↓ proinsulin level ↓proinsulin/insulin ratio	[98]
	patients with T2DM anagliptin 200 mg/day for 3 months	↓ waist size ↓ plasma glucose ↓ HOMA-IR ↓ glycoalbumin ↓ HbA1c ↓ total cholesterol ↓ TG ↓ LDL ↓ apoliporpotein B ↓ apoliporpotein B48 ↓ high molecular weight adiponectin	[102]
	T2DM patients with no history of cardiovascular diseases alogliptin 24 months	↓ thickness of the carotid arteries ↓ serum IL-6 concentration ↓ serum intercellular adhesion molecule-1 concentration ↓ serum vascular cell adhesion molecule-1 concentration	[103]
Anti-hypertension	Patients with T2DM and hypertension sitagliptin 50 mg on alternative days for 6 months	↓ systolic blood pressure ↓ HbA1c	[108]
	Patients with T2DM and hypertension vildagliptin 100 mg/day, twice a day, for 12 weeks	↑ endothelial function ↓ arterial stiffness	[110]
glycaemia control	T2DM patients sitagliptin 50 mg/day for 12 weeks	↓ blood glucose ↑ active glucagone like peptide-1 (GLP-1) ↑ active gastric inhibitory polypeptide (GIP) ↓ total GLP-1 ↓ total GIP ↓ glucagon	[116]
	T2DM patients sitagliptin, 100 mg/day + metformin, for 52 weeks	↓ HbA1c no body weight gain no hypoglycemia events	[117]
	T2DM patients on glimepiride Vildagliptin was added 50 mg/day, 24 weeks	↓ HbA1c	[125]
	T2DM patients on insulin therapy ± metformin vildagliptin was added 50 mg/day, twice a day, 24 weeks	↓ HbA1c ↓ hypoglycemia	[126]
	T2DM patients on sulfonylurea ± metformin sulfonylurea was switched to sitagliptin 100 mg/day	↓ hypoglycemia in T2DM patients who was fasted during Ramadan	[128]
	T2DM patients teneligliptin 10 or 20 mg/day for 4 weeks	↓ 2-h post prandial glucose (2 h-PPG) ↓ fasting blood sugar (FBS) ↓ serum glucagon	[131]