Effects of vildagliptin on postprandial markers of bone resorption and calcium homeostasis in recently diagnosed, well‐controlled type 2 diabetes patients*

Background: Bone metabolism is a dynamic process that is influenced by food ingestion. Endogenous incretins have been shown to be important regulators of bone turnover. The aim of the present study was to assess whether a dipeptidylpeptidase (DPP)-4 inhibitor affects markers of bone resorption and calcium homeostasis. Methods: The present study was a single-center, double blind, randomized clinical trail. Fifty-nine drug-naive patients with type 2 diabetes (T2D) were randomized to either 1year treatment with the DPP-4 inhibitor vildagliptin (100mg, once daily; n=29) or placebo (n=30). Patients received a standardized breakfast after measurement of serum concentrations of cross-linked C-terminal telopeptide (s-CTx), a bone resorption marker influenced by food intake, before and after 50weeks treatment. Results: Vildagliptin did not change postprandial s-CTx concentrations compared with pretreatment levels (between-group ratio 1.15±0.17; P=0.320). Fasting serum alkaline phosphatase, calcium, and phosphate were also unaffected y 1year treatment with vildagliptin. Conclusions: Treatment with vildagliptin for 1year was not associated with changes in markers of bone resorption and calcium homeostasis in drug-naive patients with T2D and mild hyperglycemia. © 2011 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Blackwell Publishing Asia Pty Ltd.