Impact of glycemic control with sitagliptin on the 2-year progression of arterial stiffness: a sub-analysis of the PROLOGUE study

Cardiovascular Diabetology

Original Investigation

Mamoru Nanasato¹  Masato Iida²  Hiroaki Sano³  Toyoaki Murohara⁴  Tomoki Kitano⁵  Hirofumi Tomiyama⁶  Jun Ohno⁷  Koji Maemura⁸  Masataka Sata⁹  Atsushi Tanaka^1,10  Koichi Node^1,10  Hirotsugu Yamada^1,11  Takashi Miwa^1,12  Munehide Matsuhisa^1,13  Haruo Kamiya^1,14  Kenshi Kan^1,15 

[1] Cardiovascular Center, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan;Department of Cardiology, Mitsubishi Nagoya Hospital, Nagoya, Japan;Department of Cardiology, Nagoya Ekisaikai Hospital, Nagoya, Japan;Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan;Department of Cardiology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan;Department of Cardiology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Tokyo, Japan;Department of Cardiology, Tsushima Municipal Hospital, Tsushima, Japan;Department of Cardiovascular Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan;Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan;Department of Cardiovascular Medicine, Saga University, Saga, Japan;Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan;Department of Diabetes, Endocrinology, Metabolism and Rheumatology, Tokyo Medical University, Tokyo, Japan;Diabetes Therapeutics and Research Center, Tokushima University, Tokushima, Japan;Division of Cardiology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan;Division of Diabetes, Metabolism and Endocrinology, Tokyo Medical University Hospital, Tokyo, Japan;

关键词: Arterial stiffness;    Dipeptidyl peptidase 4 inhibitor;    Glycemic control;   

DOI  :  10.1186/s12933-016-0472-8

 received in 2016-07-21, accepted in 2016-10-26,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundNo conclusive evidence has been obtained yet on the significance of the effects of dipeptidyl peptidase-4 (DPP-4 inhibitor) treatment on the arterial stiffness in clinical settings. In addition, the effects of good glycemic control on the arterial stiffness have also not been clarified yet. As a sub-analysis of the PROLOGUE study, we examined the effect of a DPP-4 inhibitor (sitagliptin) on the 2-year progression of the arterial stiffness and also to determine the effect of good glycemic control on the rate of progression of the arterial stiffness.MethodsIn the PROLOGUE study, the study participants were either allocated to add-on sitagliptin treatment or to continued treatment with conventional anti-diabetic agents. Among the 463 participants of the PROLOGUE study, we succeeded in measuring the brachial-ankle pulse wave velocity (baPWV) at least two times during the 2-year study period in 96 subjects.ResultsThe changes in the baPWV during the study period were similar between the both groups (i.e., with/without staglipitin), overall. On the other hand, when the study subjects were divided into two groups according to the glycemic control status during the study period {good glycemic control group (GC) = hemoglobin (Hb)A1c <7.0 at both 12 and 24 months after the treatment randomization; poor glycemic control group (PC) = HbA1c ≥7.0 at either 12 months, 24 months, or both}, the 2-year increase of the baPWV was marginally significantly larger in the PC group (144 ± 235 cm/s) as compared to that the GC group (−10 ± 282 cm/s) (p = 0.036).ConclusionWhile the present study could not confirm the beneficial effect of sitagliptin per se on the arterial stiffness, the results suggested that good glycemic control appears to be beneficial for delaying the annual progression of the arterial stiffness.Trial registration University Hospital Medical Information Network Clinical Trials Registry UMIN000004490

【 授权许可】

CC BY   
© The Author(s) 2016