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Long-term Saxagliptin Treatment Improves Endothelial Function but not Pulse Wave Velocity and Intima-Media Thickness in Type 2 Diabetic Patients

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Abstract

Introduction

Pharmacological inhibition of dipeptidyl-peptidase-4 may represent a promising therapeutic approach for glucose control and vascular protection. No information is available on the effects of saxagliptin (S) on aortic pulse wave velocity, carotid intima-media thickness and flow-mediated dilation (FMD, brachial artery) in diabetes.

Aim

We investigated the long-term effects of S, as add-on therapy to metformin, on the above mentioned variables.

Methods

In 16 patients with decompensated diabetes aortic pulse wave velocity, carotid intima-media thickness and FMD, office and 24-h ambulatory blood pressure, anthropometric, biochemical and metabolic parameters were measured at baseline and after 6 and 12 months of treatment. A group of 16 compensated diabetics served as controls.

Results

The two groups showed superimposable values of the different parameters, with the exception of glycated hemoglobin, blood glucose significantly (P < 0.05) greater in the S-treated patients. In the S-group glucose metabolism and FMD significantly improved during the follow-up (from 169.3 ± 8 to 157.1 ± 9 mg/dl, P < 0.05, from 7.9 ± 0.1 to 6.9 ± 0.2%, P < 0.001 and from 3.6 ± 0.3 to 7.4 ± 0.8%, respectively P < 0.05). No significant difference was detected in the other parameters, including blood pressure.

Conclusions

Thus treatment with S added-on to metformin results in beneficial effects on endothelial function, related at least in part to the concomitant improvement in glucose metabolism. This may represent a first step in the chain of events leading to a reduction in the progression of the vascular atherogenic process.

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Authors and Affiliations

  1. Clinica Medica, Dipartimento di Medicina e Chirurgia, Università Milano-Bicocca, Via Pergolesi 33, 20090, Monza, Italy

    Raffaella Dell’Oro, Alessandro Maloberti, Francesco Nicoli, Paolo Villa, Pierluigi Gamba, Michele Bombelli, Giuseppe Mancia & Guido Grassi

  2. IRCCS Multimedica, Sesto San Giovanni, Milan, Italy

    Guido Grassi

Authors
  1. Raffaella Dell’Oro
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  2. Alessandro Maloberti
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  3. Francesco Nicoli
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  4. Paolo Villa
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  5. Pierluigi Gamba
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  6. Michele Bombelli
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  7. Giuseppe Mancia
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  8. Guido Grassi
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Correspondence to Guido Grassi.

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All Authors declare that they have no competing interest associated with this publication.

Ethical Approval and Consent to Participate

Consent was obtained and this study design was approved by the local Ethics Committee of the IRCCS Multimedica, Milan, Italy and it was in accordance with the Declaration of Helsinki.

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Dell’Oro, R., Maloberti, A., Nicoli, F. et al. Long-term Saxagliptin Treatment Improves Endothelial Function but not Pulse Wave Velocity and Intima-Media Thickness in Type 2 Diabetic Patients. High Blood Press Cardiovasc Prev 24, 393–400 (2017). https://doi.org/10.1007/s40292-017-0215-2

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  • DOI: https://doi.org/10.1007/s40292-017-0215-2

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