Effects of metformin and alogliptin on body composition in people with type 2 diabetes

AIMS/INTRODUCTION: The aim of the present study was to investigate the effects of metformin and a dipeptidyl peptidase‐4 inhibitor, alogliptin, on body composition in a 12‐week randomized add‐on trial in Japanese participants with type 2 diabetes. MATERIALS AND METHODS: A total of 84 participants with poorly controlled type 2 diabetes undergoing antidiabetic therapy were randomly assigned to receive alogliptin (25 mg, once daily) or metformin (1,000 mg, twice daily) for 12 weeks. The primary efficacy end‐point was body composition. The secondary end‐points included factors associated with decreased bodyweight. RESULTS: Compared with the baseline values, alogliptin significantly increased bodyweight (66.5 ± 19.2 to 67.6 ± 19.3 kg), body mass index (BMI; 25.4 ± 6.1 to 25.8 ± 6.3 kg/m(2)) and fat mass (20.3 ± 12.8 to 21.8 ± 14.5 kg), whereas metformin had no significant effect on body composition. Alogliptin was inferior to metformin in reducing bodyweight (0.84 ± 1.57 vs −0.35 ± 1.53 kg, P = 0.002), BMI (0.34 ± 0.69 to −0.15 ± 0.56 kg/m(2), P = 0.002) and fat mass (1.49 ± 5.06 vs −0.04 ± 1.81 kg, P = 0.042). BMI at baseline was associated with changes in bodyweight negatively in the metformin group and positively in the alogliptin group. CONCLUSIONS: Metformin and alogliptin exert opposite effects on bodyweight in type 2 diabetes patients who are overweight. The higher the BMI, the more metformin reduces bodyweight and alogliptin increases weight.