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


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2016-11-03

AUTHORS

Hirofumi Tomiyama, Takashi Miwa, Kenshi Kan, Munehide Matsuhisa, Haruo Kamiya, Mamoru Nanasato, Tomoki Kitano, Hiroaki Sano, Jun Ohno, Masato Iida, Masataka Sata, Hirotsugu Yamada, Koji Maemura, Atsushi Tanaka, Toyoaki Murohara, Koichi Node

ABSTRACT

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 More... »

PAGES

150

Journal

TITLE

Cardiovascular Diabetology

ISSUE

1

VOLUME

15

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12933-016-0472-8

DOI

http://dx.doi.org/10.1186/s12933-016-0472-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1026625639

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27809848


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30 schema:description 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
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36 schema:keywords DPP-4 inhibitors
37 GC group
38 MethodsIn
39 PC group
40 PROLOGUE study
41 addition
42 agents
43 annual progression
44 anti-diabetic agents
45 arterial stiffness
46 beneficial effects
47 brachial-ankle pulse wave velocity
48 changes
49 clinical setting
50 conclusive evidence
51 control
52 control group
53 control status
54 effect
55 evidence
56 glycemic control
57 glycemic control group
58 glycemic control status
59 good glycemic control
60 good glycemic control group
61 group
62 hand
63 hemoglobin
64 impact
65 increase
66 inhibitors
67 months
68 participants
69 period
70 poor glycemic control group
71 present study
72 progression
73 pulse wave velocity
74 randomization
75 rate
76 rate of progression
77 results
78 setting
79 significance
80 sitagliptin
81 sitagliptin treatment
82 status
83 stiffness
84 study
85 study participants
86 study period
87 study subjects
88 subjects
89 time
90 treatment
91 treatment randomization
92 velocity
93 wave velocity
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