Effect of inhibitors of dipeptidyl peptidase-4 on endothelial function and arterial stiffness
AbstractIntroduction. Diabetes mellitus type 2 is a chronic, progressive disease that can lead to the development of microand macrovascular complications. An early sign of atherosclerosis is vascular endothelial damage, which develops over many years before the onset of cardiovascular complications, may have prognostic value in coronary artery disease. It is for these reasons that created and introduced into practice new hypoglycemic agents, developed approaches for the multifactorial management of diabetes. Impact, aimed at weakening endothelial dysfunction may play a crucial role in the prevention of macrovascular disease and its negative consequences.
Aims – to evaluate the effect of inhibitors of dipeptidyl peptidase-4 on endothelial function and arterial stiffness in diabetes mellitus type 2.
Materials and methods. The study included 80 patients with type 2 diabetes type with poor glycemic control on metformin therapy earlier. In order to improve carbohydrate metabolism held intensification of hypoglycemic therapy. The methods of randomization, patients were divided into 2 groups. The first group received combined drug vildagliptin/metfor min, a second group of patients received combined drug glyburide/metformin. The observation lasted 24 weeks, during which held 2 visit: initial and final visit.
In a study being identified fasting plasma glucose, PPG, determine the level of HbA1c, endothelin 1–21 quantification by ELISA in serum using a reagent kit BioKhimMak; daily monitoring of blood glucose (using a portable system Sontinuous Glucose Monitoring System, Medtronic Minimed, USA) photoplethysmography (AngioSkan-01), followed by assessment of pulse wave contour analysis and conduct occlusion test with calculation of stiffness index, the index occlusion phase, amplitude index occlusion.
Results. On therapy vildagliptin/metformin was decreased FPG 4.2 mmol/L, reducing PPG 5.8 mmol/l, HbA1c level of 1.7%. During occlusion test signal amplitude increase from baseline was 0.4. On therapy glibenclamide/metformin decreased FPG 2.4 mmol/L, reducing PPG 3.4 mmol/l, HbA1c level of 1.2%. During occlusion test signal amplitude increase from baseline was 0.1.
Conclusions. Thus, the appointment of fixed therapy vildagliptin/metformin in patients with diabetes mellitus type 2, uncompensated on metformin alone showed effectiveness in achieving the targets FPG, PPG, HbA1c, and also noted the positive effect neglikemichesky compared with the appointment of fixed therapy glibenclamide|/metformin.
Keywords:diabetes mellitus type 2, endothelial disfunction, arterial stiffness, inhibitors of dipeptidyl peptidase-4