Dipeptidyl peptidase-4 inhibitors and osteoporosis

Sep 29, 2026

Uploaded by Damian

Editorial discusses the relationship between dipeptidyl peptidase-4 (DPP-4) inhibitors and osteoporosis in patients with type 2 diabetes mellitus (T2DM). It reviews T2DM burden, current glucose-lowering therapies, and the rationale for finding better efficacy with fewer side effects and possible additional health benefits. It highlights a Taiwanese National Health Insurance Research Database study showing lower all-cause osteoporosis risk with DPP-4 inhibitors and a dose-related preventive effect, suggesting potential benefit for higher-risk groups.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Editorial

DPP-4 inhibitors and T2DM context

Study approach using NHIRD data

Findings on osteoporosis risk and dose effect

Clinical implications and future discussion

J Chin MedAssoc EDITORIAL Dipeptidyl peptidase-4 inhibitors and osteoporosis Wen-Ling Leea,b,c, Fa-Kung Leed,e, Peng-Hui Wangb,e,f,g,* aDepartment of Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan, ROC; bInstitute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; cDepartment of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan, ROC; dDepartment of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan, ROC; eFemale Cancer Foundation, Taipei, Taiwan, ROC; fDepartment of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; gDepartment of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC Type 2 diabetes mellitus (T2DM), a noncommunicable epidemic and systemic metabolic disorder characterized by hyperglycemia due to progressive loss of adequate insulin secretion by pancreatic β cells and insulin resistance secondary to malfunction of insulin action mediated by insulin receptor, or a combination of both, is one of the biggest killers for humans due to following sequelae: mainly microvascular and/or macrovascular diseases, rising as a major health issue across the globe.1–3 T2DM management includes lifestyle intervention, pharmacologic therapy, and routine blood glucose monitoring, and all efforts attempt to prevent or delay the progression of complications and improve quality of life (QoL) .4–7 Glucose-lowering agents (antidiabetic medications) currently approved and commonly used in pharmacologic therapy contain injectable—insulin (basal and bolus), amylin agonist, glucagon-like peptide (GLP)-1 receptor agonist; and oral glucose-lowering medications—sulfonylurea (glyburide, glipizide, glimepiride), biguanide (metformin), α-glucosidase inhibitors (acarbose, miglitol), meglitinides (repaglinide, nateglinide), thiazolidinediones (pioglitazone, rosiglitazone), dipeptidyl peptidase-4 (DPP-4) inhibitors (sitagliptin, saxagliptin, linagliptin, alogliptin), and sodium-glucose cotransporter type 2 (SGLT2) inhibitors (canagliflozin, empagliflozin, dapagliflozin, ertugliflozin).4,5 Monotherapy or polypharmacy of glucose-lowering agents is based on the patient’s age, patient’s compliance, patient’s general condition, disease course, drug efficacy, and drug-related side effects.5 Therefore, the development of new T2DM drugs with better efficacy, fewer side effects, and potential repositioning for any new indications or concomitant benefits for health promotion is a problem that researchers have been actively addressing. Therefore, any research focusing on the antidiabetic medication and promoted health/or improved disease is welcome.8 In the July issue of the Journal of the Chinese Medical Association, we are happy to learn about the *Address correspondence. Dr. Peng-Hui Wang, Department of Obstetricsand Gynecology, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, [ROC. E-mail addresses: phwang@vghtpe.gov.tw](ROC. E-mail addresses: phwang@vghtpe.gov.tw); [pongpongwang@gmail.com](pongpongwang@gmail.com) (P.-H. Wang). Conflicts of interest: Dr. Peng-Hui Wang, an editorial board member at Journal of the Chinese Medical Association, had no role in the peer review process of or decision to publish this article. The other authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article. Journal of Chinese Medical Association. (2022) 85: 889-890. Received July 3, 2022; accepted July 5, 2022. doi: 10. 1097/JCMA.0000000000000775. Copyright © 2022, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/)) research addressing this type of problem.9 Dr. Chang and colleagues tried to investigate whether the use of DPP-4 inhibitors for

FAQs

Why is T2DM considered a major health problem?

T2DM is a systemic metabolic disorder characterized by hyperglycemia and progressive insulin dysfunction, leading to major microvascular and/or macrovascular complications worldwide.

Which diabetes medications are discussed as current glucose-lowering options?

The text lists injectable therapies (insulin, amylin agonists, GLP-1 receptor agonists) and oral agents including sulfonylureas, metformin, alpha-glucosidase inhibitors, meglitinides, thiazolidinediones, DPP-4 inhibitors, and SGLT2 inhibitors.

What evidence supports DPP-4 inhibitors reducing osteoporosis risk?

A Taiwan NHIRD-based study found significantly lower all-cause osteoporosis risk in the DPP-4 inhibitor group versus non–DPP-4 inhibitors, with an adjusted hazard ratio of 0.616, and a dose-related positive preventive effect.

Sep 29, 2026

Uploaded by Damian