Chihara A, Tanaka A, Morimoto T, et al. - Given that the level of low-density lipoprotein cholesterol (LDL-C) could be reduced via administering anagliptin, a dipeptidyl peptidase-4 inhibitor, researchers sought to evaluate how anagliptin affects lipid metabolism-related markers compared with sitagliptin. They performed a secondary analysis of data from the Randomized Evaluation of Anagliptin vs Sitagliptin On low-density lipoproteiN cholesterol in diabetes (REASON) trial. This trial demonstrated that relative to sitagliptin, anagliptin reduced LDL-C levels to a greater extent in patients with type 2 diabetes at a high risk of cardiovascular events and on statin therapy. In the study cohort (n = 353), measurement of cholesterol absorption (campesterol and sitosterol) and synthesis (lathosterol) markers was done at baseline and 52 weeks. The two treatment groups exhibited no significant difference in the changes of campesterol or sitosterol. Sitagliptin treatment was related to a significant increase in lathosterol concentration at 52 weeks, whereas it did not change in the anagliptin group. Based on the findings, they suggest that anagliptin reduces LDL-C level by suppressing excess cholesterol synthesis, even in combination with statin therapy.