Dipeptidyl Peptidase-4 Inhibitor, Sitagliptin, Improves Endothelial Dysfunction in Association With Its Anti-Inflammatory Effects in Patients With Coronary Artery Disease and Uncontrolled Diabetes
Dipeptidyl Peptidase-4 Inhibitor, Sitagliptin, Improves Endothelial Dysfunction in Association With Its Anti-Inflammatory Effects in Patients With Coronary Artery Disease and Uncontrolled Diabetes
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DOI：
10.1253/circj.cj-12-1168
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发表时间：
2013-05-01
影响因子：
3.3
通讯作者：
Ogawa, Hisao
中科院分区：
文献类型：
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作者：
Matsubara, Junichi;Sugiyama, Seigo;Ogawa, Hisao
背景：二肽基肽酶4(DPP4)抑制剂用于糖尿病的治疗。我们假设DPP4抑制剂西格列汀可以改善糖尿病合并冠心病(CAD)患者的内皮功能障碍。方法与结果：40例冠心病和未控制的DM患者，年龄68.7+/-9.4岁(平均标准差)(50%男性，血红蛋白A(1c)[HbA(1c)]7.4+/-1.0%)被分配到西格列汀(50 mg/d，n=20)或积极的常规治疗(n=20，n=20)治疗6个月。用反应性充血周围动脉测压指数(RHI)评价血管内皮功能。基线时的临床特征在两组之间没有差异。治疗后，两组间的空腹血糖、胰岛素水平和血脂谱无差异。两组患者的HbA(1c)水平均有明显改善。西格列汀组RHI百分比变化明显大于对照组(62.4+/-59.2%vs.15.9+/-22.0%，P
Background: Dipeptidyl peptidase 4 (DPP4) inhibitors are used for treatment of diabetes mellitus (DM). We hypothesized that sitagliptin, a DPP4-inhibitor, could improve endothelial dysfunction in DM patients with coronary artery disease (CAD).Methods and Results: The 40 patients with CAD and uncontrolled DM, aged 68.7+/-9.4 years (mean standard deviation) (50% males, hemoglobin A(1c) [HbA(1c)] 7.4+/-1.0%) were assigned to either additional treatment with sitagliptin (50 mg/day, n=20) or aggressive conventional treatment (control, n=20) for 6 months. Endothelial function was assessed by the reactive hyperemia peripheral arterial tonometry index (RHI). The clinical characteristics at baseline were not different between the groups. After treatment, fasting blood glucose and insulin levels, and lipid profiles were not different between the groups. HbA(1c) levels significantly improved similarly in both groups. The percent change in RHI was greater in the sitagliptin group than in the control group (62.4+/-59.2% vs. 15.9+/-22.0%, P