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 1 year treatment with the DPP-4 inhibitor vildagliptin (100 mg, once daily; n = 29) or placebo (n = 30). Patients received a standardized breakfast after measurement of serum concentrations of crosslinked C-terminal telopeptide (s-CTx), a bone resorption marker influenced by food intake, before and after 50 weeks 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 1 year treatment with vildagliptin. Conclusions: Treatment with vildagliptin for 1 year was not associated with changes in markers of bone resorption and calcium homeostasis in drug-naive patients with T2D and mild hyperglycemia.