open access

Vol 8, No 6 (2019)
ORIGINAL ARTICLES
Published online: 2020-01-08
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The effect of linagliptin treatment on gut microbiota in patients with HNF1A-MODY or type 2 diabetes — a preliminary cohort study

Sandra Mrozinska, Tomasz Gosiewski, Agnieszka Sroka-Oleksiak, Magdalena Szopa, Małgorzata Bulanda, Maciej T Malecki, Tomasz Klupa
DOI: 10.5603/DK.2019.0024
·
Clinical Diabetology 2019;8(6):263-270.

open access

Vol 8, No 6 (2019)
ORIGINAL ARTICLES
Published online: 2020-01-08

Abstract

Introduction. Many studies have evaluated the relationship between diabetes and microbiota. In animal models, the dipeptidyl peptidase-4 inhibitors altered the gut microbiota. We investigated whether linagliptin alters the gastrointestinal flora in humans.

Materials and methods. This prospective cohort study enrolled 24 patients: 5 patients with maturity onset diabetes of the young associated with HNF1A mutation and 19 patients with type 2 diabetes mellitus. Stool samples were collected at baseline and 4 weeks after treatment intensification with either linagliptin or a sulphonylurea alongside current treatment. Faecal 16S rRNA was analysed by next-generation sequencing.

Results. Nine patients initiated linagliptin whereas 15 patients initiated or increased the dose of a sulphonylurea. After linagliptin treatment, we did not observe changes in taxa in L2–L7 based on analysis of composition of microbiomes (ANCOM). The same held true for pairwise alpha diversity (Shannon diversity, p = 0.59; Pielou’s measure of evenness, p = 0.68; and observed operational taxonomic units [OTUs], p = 0.77) and beta diversity distances (unweighted UniFrac, p = 0.99; weighted UniFrac, p = 0.93; Bray-Curtis, p = 0.98; and Jaccard, p = 0.99). Similarly, after sulphonylurea intensification, we did not observe changes in taxa in L2–L7 in ANCOM, nor were there changes in alpha diversity (Shannon diversity, p = 0.19; Pielou’s measure of evenness, p = 0.21; and observed OTUs, p = 0.42) or beta diversity distances (unweighted UniFrac, p = 0.99; weighted UniFrac, p = 0.99; Bray-Curtis, p = 1; and Jaccard, p = 0.99).

Conclusion. We did not observe changes in colonic microbiota 4 weeks after addition of linagliptin to current diabetes treatment. Further studies are required to determine whether linagliptin influences the colonic microbiota in humans.

Abstract

Introduction. Many studies have evaluated the relationship between diabetes and microbiota. In animal models, the dipeptidyl peptidase-4 inhibitors altered the gut microbiota. We investigated whether linagliptin alters the gastrointestinal flora in humans.

Materials and methods. This prospective cohort study enrolled 24 patients: 5 patients with maturity onset diabetes of the young associated with HNF1A mutation and 19 patients with type 2 diabetes mellitus. Stool samples were collected at baseline and 4 weeks after treatment intensification with either linagliptin or a sulphonylurea alongside current treatment. Faecal 16S rRNA was analysed by next-generation sequencing.

Results. Nine patients initiated linagliptin whereas 15 patients initiated or increased the dose of a sulphonylurea. After linagliptin treatment, we did not observe changes in taxa in L2–L7 based on analysis of composition of microbiomes (ANCOM). The same held true for pairwise alpha diversity (Shannon diversity, p = 0.59; Pielou’s measure of evenness, p = 0.68; and observed operational taxonomic units [OTUs], p = 0.77) and beta diversity distances (unweighted UniFrac, p = 0.99; weighted UniFrac, p = 0.93; Bray-Curtis, p = 0.98; and Jaccard, p = 0.99). Similarly, after sulphonylurea intensification, we did not observe changes in taxa in L2–L7 in ANCOM, nor were there changes in alpha diversity (Shannon diversity, p = 0.19; Pielou’s measure of evenness, p = 0.21; and observed OTUs, p = 0.42) or beta diversity distances (unweighted UniFrac, p = 0.99; weighted UniFrac, p = 0.99; Bray-Curtis, p = 1; and Jaccard, p = 0.99).

Conclusion. We did not observe changes in colonic microbiota 4 weeks after addition of linagliptin to current diabetes treatment. Further studies are required to determine whether linagliptin influences the colonic microbiota in humans.

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Keywords

diabetes, HNF 1 alpha, linagliptin, microflora, sulfonylurea

About this article
Title

The effect of linagliptin treatment on gut microbiota in patients with HNF1A-MODY or type 2 diabetes — a preliminary cohort study

Journal

Clinical Diabetology

Issue

Vol 8, No 6 (2019)

Pages

263-270

Published online

2020-01-08

DOI

10.5603/DK.2019.0024

Bibliographic record

Clinical Diabetology 2019;8(6):263-270.

Keywords

diabetes
HNF 1 alpha
linagliptin
microflora
sulfonylurea

Authors

Sandra Mrozinska
Tomasz Gosiewski
Agnieszka Sroka-Oleksiak
Magdalena Szopa
Małgorzata Bulanda
Maciej T Malecki
Tomasz Klupa

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