Daisaku Masuda1,2, Takuya Kobayashi1,2, Masami Sairyou1, Hiroyuki Hanada3, Tohru Ohama1,4, Masahiro Koseki1,5, Makoto Nishida1,5, Norikazu Maeda6, Shinji Kihara6,7, Tatsuya Minami8, Koji Yanagi9, Yasushi Sakata1, Shizuya Yamashita10,2. 1. Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine. 2. Rinku General Medical Center. 3. Division of Laboratory for Clinical Investigation, Department of Medical Technology, Osaka University Hospital. 4. Department of Dental Anesthesiology, Osaka University Graduate School of Dentistry. 5. Health Care Center, Osaka University. 6. Department of Metabolism and Atherosclerosis, Osaka University Graduate School of Medicine. 7. Department of Biomedical Informatics, Division of Health Sciences, Osaka University Graduate School of Medicine. 8. Souseikai Sousei Hospital. 9. Osaka Central Hospital. 10. Department of Community Medicine, Osaka University Graduate School of Medicine.
Abstract
AIM: The morbidity of cardiovascular disease in patients with type 2 diabetes mellitus (DM) deteriorates in combination with dyslipidemia. The accumulation of remnant lipoproteins in patients with fasting and postprandial hypertriglyceridemia is highly atherogenic. The current study investigated whether the dipeptidyl peptidase-4 inhibitor sitagliptin ameliorates dyslipidemia and hyperglycemia. METHODS: We enrolled 38 patients with type 2 DM (20 males and 18 females, 65.7±9.9 years old, HbA1c levels <8.4%), and all patients gave written informed consent. Sitagliptin (50 mg/day) was added to current antidiabetic treatments and increased to 100 mg/day to achieve low HbA1c levels (<7.4%). Glucose and lipoprotein metabolism profiles were analyzed at 0, 4, and 12 weeks after sitagliptin administration. RESULTS: Sitagliptin significantly decreased fasting levels of triglyceride (TG) (161±90 vs. 130±66 mg/dl, p<0.01) and non-HDL-C (129±29 vs. 116±20 mg/dl, p<0.01) in combination with glucose (150±47 vs. 129±27 mg/dl, p<0.01) and HbA1c (7.1±0.6 vs. 6.6±0.7 mg/dl, p<0.001). Sitagliptin also significantly decreased the fasting levels of apolipoprotein (apo) B-48 (7.8±6.7 vs. 5.6±4.0 µg/ml, p<0.01), remnant lipoprotein cholesterol (15.3±9.5 vs. 12.0±7.9 mg/dl, p<0.05) and other apolipoproteins, such as apoB, apoC-II, apoC-III, and apoE. Analyses of the lipoprotein profiles of fasting sera revealed that sitagliptin significantly decreased cholesterol and TG levels of lipoprotein fractions in the size of very low density lipoprotein and low density lipoprotein. CONCLUSIONS: These findings indicated that sitagliptin administration ameliorated the lipid and lipoprotein profiles in patients with diabetes, which may be due to the decrease in atherogenic remnant lipoproteins (UMIN#000013218).
AIM: The morbidity of cardiovascular disease in patients with type 2 diabetes mellitus (DM) deteriorates in combination with dyslipidemia. The accumulation of remnant lipoproteins in patients with fasting and postprandial hypertriglyceridemia is highly atherogenic. The current study investigated whether the dipeptidyl peptidase-4 inhibitor sitagliptin ameliorates dyslipidemia and hyperglycemia. METHODS: We enrolled 38 patients with type 2 DM (20 males and 18 females, 65.7±9.9 years old, HbA1c levels <8.4%), and all patients gave written informed consent. Sitagliptin (50 mg/day) was added to current antidiabetic treatments and increased to 100 mg/day to achieve low HbA1c levels (<7.4%). Glucose and lipoprotein metabolism profiles were analyzed at 0, 4, and 12 weeks after sitagliptin administration. RESULTS:Sitagliptin significantly decreased fasting levels of triglyceride (TG) (161±90 vs. 130±66 mg/dl, p<0.01) and non-HDL-C (129±29 vs. 116±20 mg/dl, p<0.01) in combination with glucose (150±47 vs. 129±27 mg/dl, p<0.01) and HbA1c (7.1±0.6 vs. 6.6±0.7 mg/dl, p<0.001). Sitagliptin also significantly decreased the fasting levels of apolipoprotein (apo) B-48 (7.8±6.7 vs. 5.6±4.0 µg/ml, p<0.01), remnant lipoprotein cholesterol (15.3±9.5 vs. 12.0±7.9 mg/dl, p<0.05) and other apolipoproteins, such as apoB, apoC-II, apoC-III, and apoE. Analyses of the lipoprotein profiles of fasting sera revealed that sitagliptin significantly decreased cholesterol and TG levels of lipoprotein fractions in the size of very low density lipoprotein and low density lipoprotein. CONCLUSIONS: These findings indicated that sitagliptin administration ameliorated the lipid and lipoprotein profiles in patients with diabetes, which may be due to the decrease in atherogenic remnant lipoproteins (UMIN#000013218).
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