Effects Of Sitagliptin On Serum Cytokines Of Latent Autoimmune Diabetes In Adults Patients

Objective:To investigate whether the serum cytokines in LADA patients were abnormal and whether sitagliptin could exert effects on the serum cytokines levels of LADA patients.Methods:Thirty LADA patients were recruited and randomized in a1:1ratio to group A treated with insulin and sitagliptin100mg/day (n=15) and group B treated with insulin only (n=15). The intervention lasted for12months and the patients were followed at the baseline,6and12months seperately. Fasting and2-hour postprandial serum samples and clinical data were collected at every visit. Thirty normal subjects matched with LADA patients by age and sex were selected. Serum IL-6, IL-1RA, Adiponectin, IP-10and Leptin levels were determined by the human premixed multi-analyte kit. All the cytokines were compared between LADA patients (baseline data) and normal controls. Meanwhile, they were also monitored in the above two LADA groups at the baseline,6month and12months during the follow-up.Results:(1) The serum Adiponectin [1.11(0.99-1.28) vs0.96(0.73-1.12), P=0.021] and IL-1RA [865.63(682.04-1044.55) vs718.63(478.39-807.89), P=0.012] levels in LADA patients were significantly higher than those in normal controls, whereas the serum Leptin level [4832.72(1751.9-9084.29) vs8123.84(844.48-14157.95), P=0.016] in LADA patients was lower than that in normal controls. There were no significant differences in serum IL-6and IP-10levels between the two groups. Moreover, the serum Leptin level in LADA patients was positively correlated to BMI (r=0.535, P=0.002) and was negatively correlated to GADA titers (r=-0.551, P=0.002).(2)12months later, the serum IL-1RA level in insulin with sitagliptin group and insulin without sitagliptin group both decreased compared with those in the baseline. However, there were no significant differences in the serum IL-1RA, Adiponectin, Leptin, IL-6and IP-10levels between the two groups during the whole treatment.Conclusions:(1) Adipocytokines and anti-inflammatory markers are abnormal in LADA patients, which indicates obeisity and systemic inflammation may be involved in the mechanism of LADA.(2) The anti-inflammatory marker are both improved in LADA patients treated with insulin with sitagliptin or without sitagliptin, therefore it seemed combined with sitagliptin further cannot improve the inflammation in LADA from this pilot study temporarily, which needs further larger-sample size cohort to verify.