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Dipeptidyl Peptidase-4 Inhibitors Improved Lipid Levels in Patients With Type 2 Diabetes: A Meta-analysis of

Lijia Zhao¹, Jie Meng^2,3, Jingjing Li¹

¹Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.

Nutrition Reviews

|November 23, 2025

Abstract

Context:

Dipeptidyl peptidase-4 inhibitors (DPP-4i) serve as an incretin-based hypoglycemic class for the treatment of type 2 diabetes (T2D). DPP-4i have been reported to produce a pleiotropic effect on lipid profiles in addition to regulation of glucose homeostasis.

Objective:

The aim of this systematic review and meta-analysis was to quantitatively evaluate the impact of DPP-4i on lipid parameters in patients with T2D.

Data Sources:

PubMed, Embase, and The Cochrane Library were systematically searched for randomized controlled trials.

Data Extraction:

Trials were identified if changes in lipid parameters, including low-density-lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides (TG), high-density-lipoprotein cholesterol (HDL-C), non-HDL-C, and apolipoprotein B (ApoB) were reported.

Data Analysis:

A total of 95 publications were identified. DPP-4i significantly reduced levels of LDL-C (-3.48 mg/dL; 95% CI, -4.77 to -2.20; I2 = 70%, P < .00001), TC (-2.59 mg/dL; 95% CI, -3.88 to -1.29; I2 = 73%, P < .0001), TG (-5.39 mg/dL; 95% CI, -8.04 to -2.75; I2 = 77%, P < .0001), and non-HDL-C (-6.27 mg/dL; 95% CI, -10.94 to -1.60; I2 = 53%, P = .008). No significant effect was found on HDL-C (-0.32 mg/dL; 95% CI, -1.19 to 0.55; I2 = 97%, P = .47) and ApoB (-0.88 mg/dL; 95% CI, -3.36 to 1.60; I2 = 36%, P = .49) during DPP-4i treatment.

Conclusion:

DDP-4i significantly improved lipid parameters including LDL-C, TC, TG, and non-HDL-C in patients with T2D. This underscores the potential cardiovascular benefits of DPP-4i and their role in improving diabetes-related outcomes.

Systematic Review Registration:

PROSPERO registration no. CRD42020175999.

Keywords:

dipeptidyl peptidase-4 inhibitors lipid parameters meta-analysis randomized controlled trials type 2 diabetes

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