Vildagliptin in addition to metformin improves retinal blood flow and erythrocyte deformability in patients with type 2 diabetes mellitus – results from an exploratory study

Cardiovascular Diabetology

Original Investigation

Andreas Pfützner¹  Michael Mitry¹  Andrea Löffler¹  Thomas Forst¹  Christine Berndt-Zipfel¹  Georg Michelson²  Markus Dworak³ 

[1] Institute for Clinical Research and Development, Parcusstrasse 8, 55116, Mainz, Germany;Interdisciplinary Centre for Ophthalmic Preventive Medicine and Imaging, Friedrich-Alexander-University, Erlangen, Germany;Novartis Pharma GmbH, Clinical and Regulatory Affairs, Nürnberg, Germany;

关键词: Erythrocyte deformability;    Retinal blood flow;    Glucose control;    Vildagliptin;    Glimepiride;   

DOI  :  10.1186/1475-2840-12-59

 received in 2013-04-02, accepted in 2013-04-03,  发布年份 2013

来源: Springer

【 摘 要 】

Numerous rheological and microvascular alterations characterize the vascular pathology in patients with type 2 diabetes mellitus (T2DM). This study investigated effects of vildagliptin in comparison to glimepiride on retinal microvascular blood flow and erythrocyte deformability in T2DM.Fourty-four patients with T2DM on metformin monotherapy were included in this randomized, exploratory study over 24 weeks. Patients were randomized to receive either vildagliptin (50 mg twice daily) or glimepiride individually titrated up to 4 mg in addition to ongoing metformin treatment. Retinal microvascular blood flow (RBF) and the arteriolar wall to lumen ratio (WLR) were assessed using a laser doppler scanner. In addition, the erythrocyte elongation index (EI) was measured at different shear stresses using laserdiffractoscopy.Both treatments improved glycaemic control (p < 0.05 vs. baseline; respectively). While only slight changes in RBF and the WLR could be observed during treatment with glimepiride, vildagliptin significantly increased retinal blood flow and decreased the arterial WLR (p < 0.05 vs. baseline respectively). The EI increased during both treatments over a wide range of applied shear stresses (p < 0.05 vs. baseline). An inverse correlation could be observed between improved glycaemic control (HbA1c) and EI (r = −0.524; p < 0.0001) but not with the changes in retinal microvascular measurements.Our results suggest that vildagliptin might exert beneficial effects on retinal microvascular blood flow beyond glucose control. In contrast, the improvement in erythrocyte deformability observed in both treatment groups, seems to be a correlate of improved glycaemic control.

【 授权许可】

Unknown   
© Berndt-Zipfel et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.