BACKGROUND: Glucose and fatty acids comprise the primary substrates for myocardial energy metabolism. The normal myocardium switches toward glucose metabolism in the setting of stress; the inability to affect such a switch is a fundamental mechanism behind "diabetic" or "insulin-resistant" cardiomyopathy. The purpose of this mechanistic study was to evaluate the effects of treatment with the dipeptidyl peptidase (DPP) 4 inhibitor sitagliptin on myocardial glucose uptake in patients with nonischemic cardiomyopathy. METHODS AND RESULTS: Twelve nondiabetic subjects with nonischemic cardiomyopathy underwent metabolic testing and assessment of myocardial glucose uptake by (18)F-fluorodeoxyglucose positron-emission tomographic/computerized tomographic imaging at baseline and after 4 weeks of sitagliptin therapy. Sitagliptin therapy resulted in a significant increase in myocardial glucose uptake (19% increase; P = .04). Although most patients had at least a slight increase in glucose uptake, there was an overall bimodal response, with 6 patients ("responders") demonstrating large increases (>20%) in glucose uptake and 6 patients ("nonresponders") demonstrating <5% increases or slight decreases. Triglyceride-high-density lipoprotein ratios significantly dropped in the 6 responders compared with the 6 nonresponders (P < .02). CONCLUSIONS: Therapy with the DPP-4 inhibitor sitagliptin results in increased myocardial glucose uptake in nondiabetic patients with nonischemic cardiomyopathy.
BACKGROUND:Glucose and fatty acids comprise the primary substrates for myocardial energy metabolism. The normal myocardium switches toward glucose metabolism in the setting of stress; the inability to affect such a switch is a fundamental mechanism behind "diabetic" or "insulin-resistant" cardiomyopathy. The purpose of this mechanistic study was to evaluate the effects of treatment with the dipeptidyl peptidase (DPP) 4 inhibitor sitagliptin on myocardial glucose uptake in patients with nonischemic cardiomyopathy. METHODS AND RESULTS: Twelve nondiabetic subjects with nonischemic cardiomyopathy underwent metabolic testing and assessment of myocardial glucose uptake by (18)F-fluorodeoxyglucose positron-emission tomographic/computerized tomographic imaging at baseline and after 4 weeks of sitagliptin therapy. Sitagliptin therapy resulted in a significant increase in myocardial glucose uptake (19% increase; P = .04). Although most patients had at least a slight increase in glucose uptake, there was an overall bimodal response, with 6 patients ("responders") demonstrating large increases (>20%) in glucose uptake and 6 patients ("nonresponders") demonstrating <5% increases or slight decreases. Triglyceride-high-density lipoprotein ratios significantly dropped in the 6 responders compared with the 6 nonresponders (P < .02). CONCLUSIONS: Therapy with the DPP-4 inhibitor sitagliptin results in increased myocardial glucose uptake in nondiabeticpatients with nonischemic cardiomyopathy.
Authors: Bárbara Torrecillas-Baena; María Ángeles Gálvez-Moreno; José Manuel Quesada-Gómez; Gabriel Dorado; Antonio Casado-Díaz Journal: Stem Cell Rev Rep Date: 2021-10-22 Impact factor: 5.739
Authors: Jan Hansen; Birgitte Brock; Hans Erik Bøtker; Albert Gjedde; Jørgen Rungby; Michael Gejl Journal: Rev Endocr Metab Disord Date: 2014-09 Impact factor: 6.514
Authors: Carsten Tschöpe; Christoph Birner; Michael Böhm; Oliver Bruder; Stefan Frantz; Andreas Luchner; Lars Maier; Stefan Störk; Behrouz Kherad; Ulrich Laufs Journal: Clin Res Cardiol Date: 2017-10-10 Impact factor: 5.460