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Cardiovasc Diabetol. 2016 Sep 13;15(1):134. doi: 10.1186/s12933-016-0438-x.

Long-term effect of sitagliptin on endothelial function in type 2 diabetes: a sub-analysis of the PROLOGUE study.

Author information

1
Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
2
Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. yhigashi@hiroshima-u.ac.jp.
3
Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. yhigashi@hiroshima-u.ac.jp.
4
Department of Cardiovascular Medicine, Tokushima University Hospital, 2-50-1 Kuramoto-cho, Tokushima, 770-0042, Japan.
5
Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-0042, Japan.
6
Department of Clinical Pharmacology and Therapeutics, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215, Japan.
7
Department of Diabetes, Endocrinology, Metabolism and Rheumatology, Tokyo Medical University, 6-1-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
8
Department of Endocrinology and Metabolism, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
9
Department of Cardiology, Hiroshima City Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-0011, Japan.
10
Department of Cardiology, Tsushima Municipal Hospital, 3-73 Tachibana-cho, Tsushima, 496-0038, Japan.
11
Department of Cardiology, Mitsubishi Nagoya Hospital, 7-8 Sotodoi-cho, Atsuta-ku, Nagoya, 456-0013, Japan.
12
Department of Cardiology, Nagoya Ekisaikai Hospital, 4-66, Syounen-cho, Nakagawa-ku, Nagoya, 454-0854, Japan.
13
Department of Cardiology, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
14
Department of Cardiovascular Medicine, Dokkyo Medical University, 880 Kitakobayashi, Mibumachi, Shimotsuga-gun, Tochigi, 321-0293, Japan.
15
Department of Cardiovascular Medicine, Saga University, 5-1-1, Nabeshima, Saga, 849-0937, Japan.
16
Department of Cardiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Shouwa-ku, Nagoya, 466-0065, Japan.

Abstract

BACKGROUND:

As a sub-analysis of the PROLOGUE study, we evaluated the long-term effect of sitagliptin, a dipeptidyl peptidase 4 inhibitor, on endothelial function in the conduit brachial artery in patients with type 2 diabetes.

METHODS:

In the PROLOGUE study, patients were randomly assigned to either add-on sitagliptin treatment (sitagliptin group) or continued conventional antihyperglycemic treatment (conventional group). Among the 463 participants in the PROLOGUE study, FMD was measured in 17 patients in the sitagliptin group and 18 patients in the conventional group at the beginning and after 12 and 24 months of treatment.

RESULTS:

HbA1c levels were significantly decreased after 12 and 24 months of treatment compared to baseline values in both groups (7.0 ± 0.4 vs. 6.6 ± 0.3 and 6.6 ± 0.4 % in the sitagliptin group; 7.0 ± 0.6 vs. 6.6 ± 0.7 and 6.6 ± 0.7 % in the conventional group; P < 0.05, respectively). There was no significant difference between FMD values at baseline and after 12 and 24 months in the sitagliptin group (4.3 ± 2.6 vs. 4.4 ± 2.1 and 4.4 ± 2.3 %, P = 1.0, respectively). Although FMD had a tendency to increase from 4.3 ± 2.4 % at baseline to 5.2 ± 1.9 % after 12 months and 5.1 ± 2.2 % after 24 months in the conventional group, there was no significant difference between FMD values at baseline and after 12 and 24 months (P = 0.36 and 0.33, respectively).

CONCLUSIONS:

Add-on sitagliptin to conventional antihyperglycemic drugs in patients with type 2 diabetes did not alter endothelial function in the conduit brachial artery measured by FMD during a 2-year study period. Sitagliptin may be used without concern for an adverse effect on endothelial function in patients with type 2 diabetes.

TRIAL REGISTRATION:

University hospital Medical Information Network (UMIN) Center: ID UMIN000004490.

KEYWORDS:

Dipeptidyl peptidase 4 inhibitor; Flow-mediated vasodilation; Type 2 diabetes

PMID:
27624168
PMCID:
PMC5022262
DOI:
10.1186/s12933-016-0438-x
[Indexed for MEDLINE]
Free PMC Article

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