Sitagliptin on carotid intima-media thickness in type 2 diabetes and hyperuricemia patients: a subgroup analysis of the PROLOGUE study

Author:

Zhao Yipin12ORCID,Wang Huawei32,Ke Dazhi32,Deng Wei32,Ji Yingying42,Yang Jiaojiao52,Lin Zebin32,Li Guoxing62,Xiao Li32,Tang Jianmin72,Chen Qingwei2

Affiliation:

1. Department of General practice, The Second Affiliated Hospital of Chongqing Medical University, No.76 Linjiang Road, Chongqing, 400010, China

2. Department of General practice, The Second Affiliated Hospital of Chongqing Medical University, No 76 Linjiang Road, Chongqing, 400010, China

3. Department of General practice, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

4. Department of Intensive Care Unit, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China

5. Department of Gastroenterology, Shanghai Songjiang District Central Hospital, Shanghai, China

6. Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

7. Department of Cardiology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China

Abstract

Background and Aims: Studies have shown that dipeptidyl peptidase-4 (DDP-4) inhibitors have anti-atherosclerotic effects. However, in the PROLOGUE study, sitagliptin failed to slow the progression of carotid intima-media thickness (CIMT) relative to conventional therapy. We conducted a post hoc analysis of the PROLOGUE study and compared the effects of sitagliptin and conventional therapy on changes in CIMT in subgroups with or without hyperuricemia. Methods: The PROLOGUE study was a randomized controlled trial of 442 patients with type 2 diabetes mellitus (T2DM). Patients were randomized to receive sitagliptin added therapy or conventional therapy. Based on the serum uric acid levels of all study populations in the PROLOGUE study, we divided them into hyperuricemia subgroup ( n = 104) and non-hyperuricemia subgroup ( n = 331). The primary outcome was changed in carotid intima-media thickness (CIMT) parameters compared with baseline during the 24 months treatment period. Results: In the hyperuricemia subgroup, compared with the conventional therapy group, the changes in the mean internal carotid artery (ICA)-IMT and max ICA-IMT at 24 months were significantly lower in the sitagliptin group [−0.233 mm, 95% confidence interval (CI) (−0.419 to 0.046), p = 0.015 and −0.325 mm, 95% CI (−0.583 to −0.068), p = 0.014], although there was no significant difference in the common carotid artery CIMT. Conclusion: The results of our analysis indicated that sitagliptin attenuated the progression of CIMT than conventional therapy in T2DM and hyperuricemia patients.

Funder

National Natural Science Foundation of China

Publisher

SAGE Publications

Subject

Medicine (miscellaneous)

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