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Linagliptin improves endothelial function in patients with type 2 diabetes: A randomized study of linagliptin effectiveness on endothelial function

AIMS/INTRODUCTION: The present multicenter, prospective, controlled, open and randomized three‐arm parallel study was designed to compare the effects of linagliptin with those of metformin on endothelial function. MATERIALS AND METHODS: Type 2 diabetes patients treated with 750 mg of metformin (hemo...

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Detalles Bibliográficos
Autores principales: Shigiyama, Fumika, Kumashiro, Naoki, Miyagi, Masahiko, Iga, Ryo, Kobayashi, Yuka, Kanda, Eiichiro, Uchino, Hiroshi, Hirose, Takahisa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5415473/
https://www.ncbi.nlm.nih.gov/pubmed/27868359
http://dx.doi.org/10.1111/jdi.12587
Descripción
Sumario:AIMS/INTRODUCTION: The present multicenter, prospective, controlled, open and randomized three‐arm parallel study was designed to compare the effects of linagliptin with those of metformin on endothelial function. MATERIALS AND METHODS: Type 2 diabetes patients treated with 750 mg of metformin (hemoglobin A1c ≥6.0% and <8.0%, n = 96) were randomized to continue metformin 750 mg/day (control group, n = 29), metformin at 1,500 mg/day (metformin group, n = 26) and metformin 750 mg/day supplemented with linagliptin 5 mg/day (linagliptin add‐on group, n = 29) and treated for 16 weeks. Vascular endothelial function was evaluated by flow‐mediated dilation. The primary end‐point was changes in flow‐mediated dilation at 16 weeks relative to baseline. RESULTS: Linagliptin significantly improved flow‐mediated dilation from baseline (4.9 ± 2.7%) to 16 weeks (6.3 ± 2.7%, P < 0.05), whereas the other groups did not show any changes. Hemoglobin A1c at 16 weeks was significantly lower in the metformin and linagliptin add‐on groups compared with the control (6.6 ± 0.6%, 6.5 ± 0.5% and 7.0 ± 0.6%, respectively). Single and multiple regression analyses showed that apolipoprotein B correlated significantly with change in flow‐mediated dilation, and apolipoprotein B was decreased only in the linagliptin add‐on group (–6.0 ± 11.3 mg/dL, P < 0.01). CONCLUSIONS: Linagliptin for 16 weeks improved endothelial function with a modest improvement in glycemic control. This effect was mediated, at least in part, by reduction in apolipoprotein B. Linagliptin has a protective role on endothelial function in patients with type 2 diabetes with moderate hyperglycemia.