Alogliptin, a Dipeptidyl Peptidase 4 Inhibitor, Prevents the Progression of Carotid Atherosclerosis in Patients With Type 2 Diabetes: The Study of Preventive Effects of Alogliptin on Diabetic Atherosclerosis (SPEAD-A)
Alogliptin, a Dipeptidyl Peptidase 4 Inhibitor, Prevents the Progression of Carotid Atherosclerosis in Patients With Type 2 Diabetes: The Study of Preventive Effects of Alogliptin on Diabetic Atherosclerosis (SPEAD-A)
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DOI：
10.2337/dc15-0781
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发表时间：
2016-01-01
期刊：
影响因子：
16.2
通讯作者：
Watada, Hirotaka
中科院分区：
文献类型：
--
作者：
Mita, Tomoya;Katakami, Naoto;Watada, Hirotaka
近年来的实验研究表明，二肽基肽酶4（DPP-4）抑制剂具有胰高血糖素样肽1依赖性和非依赖性的抗动脉粥样硬化作用。本研究调查了一种DPP-4抑制剂阿格列汀对2型糖尿病（T2 DM）患者颈动脉粥样硬化进展的影响。一项比较研究纳入了341例无明显心血管疾病史的T2 DM患者，这些患者在11个临床单位招募，并随机分配至阿格列汀治疗组（n = 172）和常规治疗组（n = 169）。主要结果是在24个月的治疗期间，通过颈动脉回声描记术测量的颈动脉平均共同和最大内膜中层厚度（IMT）的变化。与常规治疗相比，TSAlog治疗具有更有效的降糖作用（-0.3 +/- 0.7% vs. -0.1 +/-0.8%，P = 0.004），而不会增加低血糖。阿格列汀治疗后颈动脉平均总IMT和左右最大IMT的变化明显大于常规治疗后（-0.026 mm [SE 0.009] vs. 0.005 mm [SE 0.009]，P = 0.022;-0.045 mm [SE 0.018] vs. 0.011 mm [SE 0.017]，P = 0.025，和-0.079 mm [SE 0.018] vs. -0.015 mm [SE 0.018]，P = 0.013，结论：与常规治疗相比，罗格列酮治疗可减轻无明显心血管疾病的T2 DM患者颈动脉IMT的进展。
OBJECTIVERecent experimental studies have shown that dipeptidyl peptidase 4 (DPP-4) inhibitors have antiatherosclerotic benefits in glucagon-like peptide 1-dependent and -independent manners. The current study investigated the effects of alogliptin, a DPP-4 inhibitor, on the progression of carotid atherosclerosis in patients with type 2 diabetes mellitus (T2DM).RESEARCH DESIGN AND METHODSThis prospective, randomized, open-label, blinded-end point, multicenter, parallel-group, comparative study included 341 patients with T2DM free of a history of apparent cardiovascular diseases recruited at 11 clinical units and randomly allocated to treatment with alogliptin (n = 172) or conventional treatment (n = 169). Primary outcomes were changes in mean common and maximum intima-media thickness (IMT) of the carotid artery measured by carotid arterial echography during a 24-month treatment period.RESULTSAlogliptin treatment had a more potent glucose-lowering effect than the conventional treatment (-0.3 +/- 0.7% vs. -0.1 +/- 0.8%, P = 0.004) without an increase of hypoglycemia. Changes in the mean common and the right and left maximum IMT of the carotid arteries were significantly greater after alogliptin treatment than after conventional treatment (-0.026 mm [SE 0.009] vs. 0.005 mm [SE 0.009], P = 0.022; -0.045 mm [SE 0.018] vs. 0.011 mm [SE 0.017], P = 0.025, and -0.079 mm [SE 0.018] vs. -0.015 mm [SE 0.018], P = 0.013, respectively).CONCLUSIONSAlogliptin treatment attenuated the progression of carotid IMT in patients with T2DM free of apparent cardiovascular disease compared with the conventional treatment.