Affiliation:
1. Division of Cardiovascular Medicine, Department of Medicine, Kurume University School of Medicine, Kurume, 67 Asahi-machi, Japan
2. Kumashiro Hospital, Kurume, Japan
3. Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume University School of Medicine, Kurume, Japan
Abstract
Background:
We have found that anagliptin, a dipeptidyl peptidase-4 inhibitor (DPP-4) significantly
ameliorates arterial stiffness in Type 2 Diabetes Mellitus (T2DM) patients compared with an
equivalent hypoglycaemic agent, glimepiride. However, it remains unclear whether switching DPP-4
inhibitors to tofogliflozin, a selective inhibitor of Sodium-Glucose Cotransporter 2 (SGLT2) improves
arterial stiffness in T2DM patients.
Methods:
Nineteen T2DM patients who had received DPP-4 inhibitors for at least 1 year were enrolled
in this study. Clinical parameters and arterial stiffness evaluated by cardio-ankle vascular index (CAVI)
were measured at baseline and after 6-months treatment with tofogliflozin.
Results:
At 6 months after switching to tofogliflozin, CAVI, waist circumference, body weight, body
mass index, subcutaneous and visceral fat volume, white blood cell number, fasting plasma insulin, uric
acid, aspartate transaminase (AST), γ-glutamyl transferase (GTP), and advanced glycation end products
(AGEs) were significantly reduced, while red blood cell number, haemoglobin, and HbA1c values were
increased. When stratified by median values of change in CAVI after switching to tofogliflozin
(ΔCAVI), baseline serum levels of AGEs were significantly higher in the low ΔCAVI group (high responder)
than in the high one (low responder). ΔAST and ΔGTP were positively correlated with
ΔCAVI.
Conclusion:
The present study suggests that switching DPP-4 inhibitors to tofogliflozin ameliorates
arterial stiffness in T2DM patients partly via improvement of liver function. Baseline serum levels of
AGEs may identify patients who improve arterial stiffness more after treatment with tofogliflozin.
Funder
Japan Society for the Promotion of Science (JSPS KAKENHI)
Ministry of Education, Culture, Sports, Science and Technology, japan
Publisher
Bentham Science Publishers Ltd.
Subject
Cardiology and Cardiovascular Medicine,Pharmacology
Cited by
26 articles.
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