Dipeptidyl peptidase-4 inhibitors improve arterial stiffness, blood pressure, lipid profile and inflammation parameters in patients with type 2 diabetes mellitus.

Lea Duvnjak,Kristina Blaslov

doi:10.1186/s13098-016-0144-6

Abstract

BackgroundThis uncontrolled open label study evaluated the effect of dipeptidyl peptidase-4 inhibitors (DPP-4i): sitagliptin and vildagliptin on augmentation index standardized for 75 beats per minute (cAiX@75), blood pressure (BP), lipid profile and high-sensitivity C-reactive protein (hsCRP) in patients with type 2 diabetes mellitus (T2DM).MethodsFifty-one well-regulated T2DM patients were randomly assigned to either sitagliptin or vildagliptin (100 mg/day) for 3 months continuing their previous treatment. Lipid profile, cAiX@75, hsCRP, glycated hemoglobin (HbA1c) were measured at baseline at 4, 8 and 12th week were accessed. cAiX@75 and pulse wave velocity (PWV) were determined by SphygmoCor device.ResultsFollowing DPP-4 treatment there was a significant reduction in total serum cholesterol (5.18 vs 4.62 mmol/L), low-density lipoprotein (2.89 vs 2.54 mmol/L), hsCRP (3.21 vs 1.95 mg/L), cAiX@75 (24.5 vs 22.3) and central systolic BP (131.8 vs 119.5 mmHg). The sitagliptin treated group reached cAiX@75 reduction earlier in the study period while neither sitagliptin or vildagliptin use resulted in the significant HbA1c reduction.ConclusionThe treatment with DPP-4i: sitagliptin and vildagliptin provides favorable metabolic and vascular effects beyond glucose-control. Further studies are required to elucidate their implication in metabolic pathways.

Highlights

This uncontrolled open label study evaluated the effect of dipeptidyl peptidase-4 inhibitors (DPP-4i): sitagliptin and vildagliptin on augmentation index standardized for 75 beats per minute, blood pressure (BP), lipid profile and high-sensitivity C-reactive protein in patients with type 2 diabetes mellitus (T2DM)
Vildagliptin 2 × 50 mg/day was added to current diabetes therapy reigment in 20 (39.21 %) patients at the point treated with metformin only and 3 patients with gliclazide 60 mg/day + metformin 2 g/day
Sitagliptin 2 × 50 mg/day was added to 31 (60.79 %) patient treated with metformin and one patient treated with metformin (2.5 g and gliclazide 60 mg/day)

Summary

Introduction

This uncontrolled open label study evaluated the effect of dipeptidyl peptidase-4 inhibitors (DPP-4i): sitagliptin and vildagliptin on augmentation index standardized for 75 beats per minute (cAiX@75), blood pressure (BP), lipid profile and high-sensitivity C-reactive protein (hsCRP) in patients with type 2 diabetes mellitus (T2DM). According to the Framingham study type 2 diabetes mellitus (T2DM) is associated with a twofold to fourfold increased risk for cardiovascular disease (CVD) [1]. This is due to diabetes related metabolic disorders: chronic hyperglycemia and dyslipidemia along with oxidative stress and low grade inflammation [2]. GLP-1 seems to have some beneficial effect on pancreatic β-cells preservation in experimental models [7] This actions are limited due to its rapid inactivation by the dipeptidyl peptidase-4 (DPP-4) enzyme [8, Duvnjak and Blaslov Diabetol Metab Syndr (2016) 8:26

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