The Effects of Switching from Dipeptidyl Peptidase-4 Inhibitors to Glucagon-Like Peptide-1 Receptor Agonists on Bone Mineral Density in Diabetic Patients

Figures & data

Figure 1 Flow chart for study subject selection.

Abbreviations: DPP-4i, dipeptidyl peptidase-4 inhibitors; DXA, dual-energy X-ray absorptiometry; GLP-1RA, glucagon-like peptide-1 receptor agonists.

Table 1 Baseline Characteristics of Subjects

Characteristics	Study Group (DPP-4i to GLP-1RA)	Control Group (DPP-4i to DPP-4i)	p value
Sample size (n)	132	133
Age, years, mean (SD)	61.9 (6.7)	63.4 (5.9)	0.112
Women, % (n)	18.2 (24)	16.5 (22)	0.388
Weight, kg, mean (SD)	69.3 (6.1)	66.3 (4.5)	0.224
BMI, kg/m^2, mean (SD)	26.8 (1.3)	26.2 (1.2)	0.311
HbA1c, %, mean (SD)	8.8 (0.6)	8.7 (0.7)	0.269
TC, mg/dL, mean (SD)	188.2 (21.9)	195.7 (18.6)	0.083
TG, mg/dL, mean (SD)	211.2 (32.8)	215.4 (39.7)	0.452
Creatinine, mg/dL, mean (SD)	1.2 (0.3)	1.2 (0.4)	0.788
Using metformin, % (n)	83.3 (110)	85.7 (114)	0.192
Using sulfonylureas, % (n)	59.8 (79)	51.1 (68)	0.087
BMD, g/cm^2, mean (SD)
Lumbar spine	0.822 (0.151)	0.792 (0.147)	0.081
Femoral neck	0.791 (0.144)	0.788 (0.148)	0.477

Abbreviations: BMD, bone mineral density; BMI, body mass index; DPP-4i, dipeptidyl peptidase-4 inhibitors; GLP-1RA, glucagon-like peptide-1 receptor agonists; HbA1c, glycosylated hemoglobin; SD, standard deviation; TC, total cholesterol; TG, triglycerides.

Table 2 Clinical Data Comparison with and without Switching from DPP-4i to GLP-1RA

Differences Between Two DXAs	DPP-4i to GLP-1RA (n = 132)	DPP-4i to DPP-4i (n = 133)	Difference Between-Group^b
Duration, years, mean (SD)	3.0 (0.4)	3.3 (0.6)
HbA1c, %, mean (SD)	−1.3 (0.5)	−0.7 (0.4)	p = 0.027^b
	p < 0.001^a	p = 0.033^a
BMD, g/cm^2, mean (SD)
Lumbar spine	−0.028 (0.013)	−0.019 (0.021)	p = 0.041^b
	p = 0.002^a	p = 0.083
Femoral neck	−0.007 (0.015)	−0.004 (0.005)	p = 0.183
	p = 0.433	p = 0.171

Notes: ^aThe paired t-test revealed a difference when compared to the baseline. ^bThe differences were adjusted for age and BMI by ANCOVA.

Abbreviations: BMD, bone mineral density; DPP-4i, dipeptidyl peptidase-4 inhibitors; DXA, dual-energy X-ray absorptiometry; GLP-1RA, glucagon-like peptide-1 receptor agonists; HbA1c, glycosylated hemoglobin; SD, standard deviation.