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)

被引：115

作者：

Mita, Tomoya ^{[1
,2
]}

Katakami, Naoto ^{[3
,4
]}

Yoshii, Hidenori ^{[5
]}

Onuma, Tomio ^{[5
]}

Kaneto, Hideaki ^{[3
]}

Osonoi, Takeshi ^{[6
]}

Shiraiwa, Toshihiko ^{[7
]}

Kosugi, Keisuke ^{[8
]}

Umayahara, Yutaka ^{[9
]}

Yamamoto, Tsunehiko

Yokoyama, Hiroki ^{[10
]}

Kuribayashi, Nobuichi ^{[11
]}

Jinnouchi, Hideaki ^{[12
]}

Gosho, Masahiko ^{[13
]}

Shimomura, Iichiro ^{[3
]}

Watada, Hirotaka ^{[1
,2
,14
]}

机构：

[1] Juntendo Univ, Grad Sch Med, Dept Endocrinol & Metab, Tokyo, Japan

[2] Juntendo Univ, Ctr Mol Diabetol, Grad Sch Med, Tokyo, Japan

[3] Osaka Univ, Grad Sch Med, Dept Metab Med, Osaka, Japan

[4] Osaka Univ, Grad Sch Med, Dept Metab & Atherosclerosis, Osaka, Japan

[5] Juntendo Tokyo Koto Geriatr Med Ctr, Dept Med Diabetol & Endocrinol, Tokyo, Japan

[6] Naka Mem Clin, Ibaraki, Japan

[7] Shiraiwa Med Clin, Osaka, Japan

[8] Osaka Police Hosp, Osaka, Japan

[9] Osaka Gen Med Ctr, Osaka, Japan

[10] Jiyugaoka Med Clin, Internal Med, Sapporo, Hokkaido, Japan

[11] Misaki Naika Clin, Chiba, Japan

[12] Jinnouchi Hosp, Kumamoto, Japan

[13] Univ Tsukuba, Fac Med, Dept Clin Trial & Clin Epidemiol, Ibaraki, Japan

[14] Juntendo Univ, Grad Sch Med, Ctr Therapeut Innovat Diabet, Tokyo, Japan

来源：

DIABETES CARE | 2016年 / 39卷 / 01期

关键词：

INTIMA-MEDIA THICKNESS; ACUTE GLUCOSE FLUCTUATIONS; CARDIOVASCULAR EVENTS; ENDOTHELIAL FUNCTION; OXIDATIVE STRESS; RECEPTOR AGONIST; DPP-4; INHIBITOR; SITAGLIPTIN; INFLAMMATION; PIOGLITAZONE;

D O I：

10.2337/dc15-0781

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

OBJECTIVE Recent 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 METHODS This 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. RESULTS Alogliptin 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). CONCLUSIONS Alogliptin treatment attenuated the progression of carotid IMT in patients with T2DM free of apparent cardiovascular disease compared with the conventional treatment.

引用

页码：139 / 148

页数：10

共 40 条

[1] Inhibition of Monocyte Adhesion to Endothelial Cells and Attenuation of Atherosclerotic Lesion by a Glucagon-like Peptide-1 Receptor Agonist, Exendin-4 [J].