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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概要
- 論文の詳細を見る
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 A1c [HbA1c] 7.4±1.0%) were assigned to either additional treatment with sitagliptin (50mg/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. HbA1c 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<0.01). Furthermore, treatment with sitagliptin resulted in a significant decrease in the high-sensitivity C-reactive protein (hsCRP) level, but no such change was noted in the control group. Linear regression analysis demonstrated a significant negative relation between changes in RHI and hsCRP, but not between RHI and HbA1c. Conclusions: Sitagliptin significantly improved endothelial function and inflammatory state in patients with CAD and uncontrolled DM, beyond its hypoglycemic action. These findings suggest that sitagliptin has beneficial effects on the cardiovascular system in DM patients. (Circ J 2013; 77: 1337–1344)
著者
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Kaikita Koichi
Department Of Cardiovascular Medicine Graduate School Of Medical Sciences Kumamoto University
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Sugiyama Seigo
Department Of Cardiovascular Medicine Graduate School Of Medical Science Kumamoto University
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Hokimoto Seiji
Department Of Cardiovascular Medicine Graduate School Of Medical Sciences Kumamoto University
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Akiyama Eiichi
Department Of Cardiology Fujisawa Municipal Hospital
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Matsubara Junichi
Department of Cardiovascular Medicine Graduate School of Medical Sciences Kumamoto University
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Maeda Hirofumi
Department Of Radiology Nagasaki University School Of Medicine
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Iwashita Satomi
Department Of Cardiovascular Medicine Graduate School Of Medical Sciences Kumamoto University
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Ogawa Hisao
Department Cardiovascular Medicine Kumamoto University:division Of Intensive Care Unit Kumamoto Univ
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Ohba Keisuke
Department Of Cardiovascular Center National Hospital Organization Kumamoto Medical Center
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Yamamoto Eiichiro
Department Of Biochemistry Cancer Research Institute
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Jinnouchi Hideaki
Department Of Internal Medicine Jinnochi Hospital
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Kurokawa Hirofumi
Department of Cardiovascular Medicine, Faculty of Life Sciences, Kumamoto University
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Fujisue Koichiro
Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University
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Ogawa Hisao
Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University
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Hokimoto Seiji
Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University
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Iwashita Satomi
Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University
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Matsubara Junichi
Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University
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Kurokawa Hirofumi
Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University
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Sugiyama Seigo
Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University
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Yamamoto Eiichiro
Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University
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Maeda Hirofumi
Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University
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