Abstract 10720: Sitagliptin Provides Multiple Antiatherosclerotic Effects Independent of Diabetic Improvement for Type-2 Diabetics With or Without Insulin Therapies
Background: Diabetes mellitus is thought to be highly involved in complex atherothrombogenic processes, but the antiatherosclerotic therapies in diabetic patients have not been established.We assessed hypothesis sitagliptin, a dipeptidyl peptidase-4 inhibitor (DPP4I) recently developed antidiabetic agent, inhibits atherosclerotic progression in diabetic patients.
Methods: Type-2 diabetic patients with or without insulin therapies were randomized to group-S where they received sitagliptin, or to group-C where they continued therapy without a DPP4I for 6 months. We quantified flow-mediated endothelium-dependent dilatation of brachial artery after 5 minutes forearm occlusion (FMD) using high-resolution ultrasonography, and we also quantified brachial-to-ankle pulse wave velocity (PWV). Changes in FMD and PWV were compared between the 2 groups.
Results: The patients in group-S (n=18) manifested improvements in metabolic variables represented by HbA1c and LDL after medication, while those in group-C (n=18) showed no improvement. In group-S FMD (%) increased both in patients with insulin therapies (from 3.4±2.5 to 5.9±2.9, p=0.02) and in those without insulin therapies (from 3.9±2.1 to 6.5±2.8, p<0.01), while in group-C it remained unchanged both in those with insulin therapies (from 3.6±2.9 to 3.8±2.8, p=0.63) and in those without insulin therapies (from 4.0±1.9 to 4.1±2.4, p=0.86). In group-S PWV (cm/s) decreased in those with insulin therapies (from 1915±256 to 1845±234, p=0.04) and in those without insulin therapies (from 1780±230 to 1693±244, p=0.02), but in group-C it remained unchanged in those with insulin therapies (from 1867±283 to 1888±290, p=0.79) and in those without insulin therapies (from 1761±246 to 1792±259, p=0.59). Changes of FMD or PWV in group-S did not correlate to those of HbA1c in those with insulin therapies (FMD: r=0.12, p=0.78, PWV: r=0.16, p=0.58) or in those without insulin therapies (FMD: r=0.24, p=0.41, PWV: r=0.19, p=0.46).
Conclusion: These results indicate sitagliptin provides multiple antiatherosclerotic effects independent of diabetic improvement, which may have novel potential benefit of a DPP4I for management of progressive atherosclerosis in type-2 diabetics with or without insulin therapies.
- © 2012 by American Heart Association, Inc.