Dipeptidyl peptidase-4 inhibitor might exacerbate Graves' disease: A multicenter observational case-control study

J Diabetes Investig. 2021 Nov;12(11):1978-1982. doi: 10.1111/jdi.13578. Epub 2021 Jun 16.

Abstract

Dipeptidyl peptidase-4 (DPP-4), namely CD26, is expressed on the surface of immune cells, suggesting that inhibition of DPP-4 might affect the immune system. The current multicenter observational case-control study was carried out to investigate the effects of DPP-4 inhibitor (DPP-4i) administration on Graves' disease (GD) activity. This study comprised patients with GD and type 2 diabetes, who were administered an oral hypoglycemic agent including DPP-4i. Exacerbation of GD was defined as an increase of antithyroid drug dose by 6 months after oral hypoglycemic agent administration. A total of 80 patients were enrolled and divided into an exacerbation group or a non-exacerbation group. The frequency of DPP-4i administration was significantly higher in the exacerbation group (88%) than that in the non-exacerbation group (31%). In multivariate logistic regression analysis, there was a significant association between DPP-4i administration and GD exacerbation (odds ratio 7.39). The current study suggests that DPP-4i administration is associated with GD exacerbation.

Keywords: Case-control study; Dipeptidyl peptidase-4; Graves' disease.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Antithyroid Agents / administration & dosage*
  • Case-Control Studies
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / immunology
  • Dipeptidyl Peptidase 4 / drug effects
  • Dipeptidyl Peptidase 4 / immunology
  • Dipeptidyl-Peptidase IV Inhibitors / adverse effects*
  • Dipeptidyl-Peptidase IV Inhibitors / immunology
  • Disease Progression
  • Female
  • Graves Disease / drug therapy
  • Graves Disease / immunology*
  • Humans
  • Hypoglycemic Agents / adverse effects*
  • Hypoglycemic Agents / immunology
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio

Substances

  • Antithyroid Agents
  • Dipeptidyl-Peptidase IV Inhibitors
  • Hypoglycemic Agents
  • DPP4 protein, human
  • Dipeptidyl Peptidase 4