Journal
CURRENT VASCULAR PHARMACOLOGY
Volume 14, Issue 6, Pages 552-562Publisher
BENTHAM SCIENCE PUBL LTD
DOI: 10.2174/1570161114666160625090212
Keywords
Arterial stiffness; cardio-ankle vascular index; cardiovascular disease; DPP-4 inhibitors; diabetes mellitus
Funding
- Mitsui Life Social Welfare Foundation
- Kimura Memorial Foundation
- Medical Care Education Research Foundation
- Ministry of Education, Culture, Sports, Science and Technology, Japan
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Background: Inhibition of dipeptidyl peptidase-4 (DPP-4) has been proposed as a therapeutic target for type 2 diabetes (T2DM). Arterial stiffness, a predictor of future cardiovascular events and all-cause mortality, is augmented in these patients. However, effects of DPP-4 inhibitors on arterial stiffness remain unknown. In this study, we compared effects of anagliptin, an inhibitor of DPP-4 on arterial stiffness evaluated by cardio-ankle vascular index (CAVI) with those of an equipotent glucose-lowering agent, glimepiride in patients with T2DM. Methods: The study involved 50 consecutive outpatients (33 males and 17 females; mean age of 72.5 +/- 9.5 years) who visited our hospitals for a risk-screening test or treatment for T2DM. They underwent complete history and physical examination, and determination of blood chemistry and anthropometric variables, and then were randomized to receive either anagliptin (n=26) or glimepiride (n=24) for 6 months. Results: After 6-months treatment, fasting plasma glucose and HbA1c values were comparably reduced in both groups. Anagliptin, but not glimepiride treatment significantly decreased low-density lipoprotein cholesterol, malondialdehyde-modified LDL, remnant-like particle (RLP) cholesterol, CAVI, alanine transaminase (ALT), gamma-glutamyl transferase and visceral fat volume. In multiple regression analysis, absolute changes from baseline of RLP cholesterol and ALT after anagliptin treatment for 6 months (Delta RLP cholesterol and Delta ALT) were independently correlated with Delta CAVI (R-2 = 0.445). Conclusion: The present study suggests that anagliptin may exert a beneficial effect on arterial stiffness in patients with T2DM, which is independent of its blood glucose-lowering property. Anagliptin may ameliorate arterial stiffness partly via reduction of RLP cholesterol and improvement of liver function.
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