Comparison of effects of sitagliptin and voglibose on left ventricular diastolic dysfunction in patients with type 2 diabetes

Results of the 3D trial

Hiroki Oe

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Left ventricular (LV) diastolic dysfunction is frequently observed in patients with type 2 diabetes. Dipeptidyl peptidase-4 inhibitor (DPP-4i) attenuates postprandial hyperglycemia (PPH) and may have cardio-protective effects. It remains unclear whether DPP-4i improves LV diastolic function in patients with type 2 diabetes, and, if so, it is attributable to the attenuation of PPH or to a direct cardiac effect of DPP-4i. We compared the effects of the DPP-4i, sitagliptin, and the alpha-glucosidase inhibitor, voglibose, on LV diastolic function in patients with type 2 diabetes. Methods: We conducted a prospective, randomized, open-label, multicenter study of 100 diabetic patients with LV diastolic dysfunction. Patients received sitagliptin (50mg/day) or voglibose (0.6mg/day). The primary endpoints were changes in the e' velocity and E/e' ratio from baseline to 24weeks later. The secondary efficacy measures included HbA1c, GLP-1, lipid profiles, oxidative stress markers and inflammatory markers. Results: The study was completed with 40 patients in the sitagliptin group and 40 patients in the voglibose group. There were no significant changes in the e' velocity and E/e' ratio from baseline to 24weeks later in both groups. However, analysis of covariance demonstrated that pioglitazone use is an independent factor associated with changes in the e' and E/e' ratio. Among patients not using pioglitazone, e' increased and the E/e' ratio decreased in both the sitagliptin and voglibose groups. GLP-1 level increased from baseline to 24weeks later only in the sitagliptin group (4.8 ± 4.7 vs. 7.3 ± 5.5 pmol/L, p <0.05). The reductions in HbA1c and body weight were significantly greater in the sitagliptin group than in the voglibose group (-0.7 ± 0.6% vs. -0.3 ± 0.4, p <0.005; -1.3 ± 3.2kg vs. 0.4 ± 2.8kg, p <0.05, respectively). There were no changes in lipid profiles and inflammatory markers in both groups. Conclusions: Our trial showed that sitagliptin reduces HbA1c levels more greatly than voglibose does, but that neither was associated with improvement in the echocardiographic parameters of LV diastolic function in patients with diabetes. Trial registration: Registered at http://www.umin.ac.jp under UMIN000003784.

Original languageEnglish
Article number83
JournalCardiovascular Diabetology
Volume14
Issue number1
DOIs
Publication statusPublished - Jun 19 2015

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Left Ventricular Dysfunction
Type 2 Diabetes Mellitus
Dipeptidyl-Peptidase IV Inhibitors
pioglitazone
Left Ventricular Function
Glucagon-Like Peptide 1
Hyperglycemia
Lipids
Sitagliptin Phosphate
voglibose
Multicenter Studies
Oxidative Stress
Body Weight

Keywords

  • Alpha-glucosidase inhibitor
  • Dipeptidyl peptidase 4 (DPP-4) inhibitors
  • LV diastolic function

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

@article{473a2c458a484f24a1d807cb7ecf024b,
title = "Comparison of effects of sitagliptin and voglibose on left ventricular diastolic dysfunction in patients with type 2 diabetes: Results of the 3D trial",
abstract = "Background: Left ventricular (LV) diastolic dysfunction is frequently observed in patients with type 2 diabetes. Dipeptidyl peptidase-4 inhibitor (DPP-4i) attenuates postprandial hyperglycemia (PPH) and may have cardio-protective effects. It remains unclear whether DPP-4i improves LV diastolic function in patients with type 2 diabetes, and, if so, it is attributable to the attenuation of PPH or to a direct cardiac effect of DPP-4i. We compared the effects of the DPP-4i, sitagliptin, and the alpha-glucosidase inhibitor, voglibose, on LV diastolic function in patients with type 2 diabetes. Methods: We conducted a prospective, randomized, open-label, multicenter study of 100 diabetic patients with LV diastolic dysfunction. Patients received sitagliptin (50mg/day) or voglibose (0.6mg/day). The primary endpoints were changes in the e' velocity and E/e' ratio from baseline to 24weeks later. The secondary efficacy measures included HbA1c, GLP-1, lipid profiles, oxidative stress markers and inflammatory markers. Results: The study was completed with 40 patients in the sitagliptin group and 40 patients in the voglibose group. There were no significant changes in the e' velocity and E/e' ratio from baseline to 24weeks later in both groups. However, analysis of covariance demonstrated that pioglitazone use is an independent factor associated with changes in the e' and E/e' ratio. Among patients not using pioglitazone, e' increased and the E/e' ratio decreased in both the sitagliptin and voglibose groups. GLP-1 level increased from baseline to 24weeks later only in the sitagliptin group (4.8 ± 4.7 vs. 7.3 ± 5.5 pmol/L, p <0.05). The reductions in HbA1c and body weight were significantly greater in the sitagliptin group than in the voglibose group (-0.7 ± 0.6{\%} vs. -0.3 ± 0.4, p <0.005; -1.3 ± 3.2kg vs. 0.4 ± 2.8kg, p <0.05, respectively). There were no changes in lipid profiles and inflammatory markers in both groups. Conclusions: Our trial showed that sitagliptin reduces HbA1c levels more greatly than voglibose does, but that neither was associated with improvement in the echocardiographic parameters of LV diastolic function in patients with diabetes. Trial registration: Registered at http://www.umin.ac.jp under UMIN000003784.",
keywords = "Alpha-glucosidase inhibitor, Dipeptidyl peptidase 4 (DPP-4) inhibitors, LV diastolic function",
author = "Hiroki Oe and Hiroki Oe and Kazufumi Nakamura and Hajime Kihara and Kenei Shimada and Shota Fukuda and Tsutomu Takagi and Toru Miyoshi and Kumiko Hirata and Junichi Yoshikawa and Hiroshi Itoh",
year = "2015",
month = "6",
day = "19",
doi = "10.1186/s12933-015-0242-z",
language = "English",
volume = "14",
journal = "Cardiovascular Diabetology",
issn = "1475-2840",
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number = "1",

}

TY - JOUR

T1 - Comparison of effects of sitagliptin and voglibose on left ventricular diastolic dysfunction in patients with type 2 diabetes

T2 - Results of the 3D trial

AU - Oe, Hiroki

AU - Oe, Hiroki

AU - Nakamura, Kazufumi

AU - Kihara, Hajime

AU - Shimada, Kenei

AU - Fukuda, Shota

AU - Takagi, Tsutomu

AU - Miyoshi, Toru

AU - Hirata, Kumiko

AU - Yoshikawa, Junichi

AU - Itoh, Hiroshi

PY - 2015/6/19

Y1 - 2015/6/19

N2 - Background: Left ventricular (LV) diastolic dysfunction is frequently observed in patients with type 2 diabetes. Dipeptidyl peptidase-4 inhibitor (DPP-4i) attenuates postprandial hyperglycemia (PPH) and may have cardio-protective effects. It remains unclear whether DPP-4i improves LV diastolic function in patients with type 2 diabetes, and, if so, it is attributable to the attenuation of PPH or to a direct cardiac effect of DPP-4i. We compared the effects of the DPP-4i, sitagliptin, and the alpha-glucosidase inhibitor, voglibose, on LV diastolic function in patients with type 2 diabetes. Methods: We conducted a prospective, randomized, open-label, multicenter study of 100 diabetic patients with LV diastolic dysfunction. Patients received sitagliptin (50mg/day) or voglibose (0.6mg/day). The primary endpoints were changes in the e' velocity and E/e' ratio from baseline to 24weeks later. The secondary efficacy measures included HbA1c, GLP-1, lipid profiles, oxidative stress markers and inflammatory markers. Results: The study was completed with 40 patients in the sitagliptin group and 40 patients in the voglibose group. There were no significant changes in the e' velocity and E/e' ratio from baseline to 24weeks later in both groups. However, analysis of covariance demonstrated that pioglitazone use is an independent factor associated with changes in the e' and E/e' ratio. Among patients not using pioglitazone, e' increased and the E/e' ratio decreased in both the sitagliptin and voglibose groups. GLP-1 level increased from baseline to 24weeks later only in the sitagliptin group (4.8 ± 4.7 vs. 7.3 ± 5.5 pmol/L, p <0.05). The reductions in HbA1c and body weight were significantly greater in the sitagliptin group than in the voglibose group (-0.7 ± 0.6% vs. -0.3 ± 0.4, p <0.005; -1.3 ± 3.2kg vs. 0.4 ± 2.8kg, p <0.05, respectively). There were no changes in lipid profiles and inflammatory markers in both groups. Conclusions: Our trial showed that sitagliptin reduces HbA1c levels more greatly than voglibose does, but that neither was associated with improvement in the echocardiographic parameters of LV diastolic function in patients with diabetes. Trial registration: Registered at http://www.umin.ac.jp under UMIN000003784.

AB - Background: Left ventricular (LV) diastolic dysfunction is frequently observed in patients with type 2 diabetes. Dipeptidyl peptidase-4 inhibitor (DPP-4i) attenuates postprandial hyperglycemia (PPH) and may have cardio-protective effects. It remains unclear whether DPP-4i improves LV diastolic function in patients with type 2 diabetes, and, if so, it is attributable to the attenuation of PPH or to a direct cardiac effect of DPP-4i. We compared the effects of the DPP-4i, sitagliptin, and the alpha-glucosidase inhibitor, voglibose, on LV diastolic function in patients with type 2 diabetes. Methods: We conducted a prospective, randomized, open-label, multicenter study of 100 diabetic patients with LV diastolic dysfunction. Patients received sitagliptin (50mg/day) or voglibose (0.6mg/day). The primary endpoints were changes in the e' velocity and E/e' ratio from baseline to 24weeks later. The secondary efficacy measures included HbA1c, GLP-1, lipid profiles, oxidative stress markers and inflammatory markers. Results: The study was completed with 40 patients in the sitagliptin group and 40 patients in the voglibose group. There were no significant changes in the e' velocity and E/e' ratio from baseline to 24weeks later in both groups. However, analysis of covariance demonstrated that pioglitazone use is an independent factor associated with changes in the e' and E/e' ratio. Among patients not using pioglitazone, e' increased and the E/e' ratio decreased in both the sitagliptin and voglibose groups. GLP-1 level increased from baseline to 24weeks later only in the sitagliptin group (4.8 ± 4.7 vs. 7.3 ± 5.5 pmol/L, p <0.05). The reductions in HbA1c and body weight were significantly greater in the sitagliptin group than in the voglibose group (-0.7 ± 0.6% vs. -0.3 ± 0.4, p <0.005; -1.3 ± 3.2kg vs. 0.4 ± 2.8kg, p <0.05, respectively). There were no changes in lipid profiles and inflammatory markers in both groups. Conclusions: Our trial showed that sitagliptin reduces HbA1c levels more greatly than voglibose does, but that neither was associated with improvement in the echocardiographic parameters of LV diastolic function in patients with diabetes. Trial registration: Registered at http://www.umin.ac.jp under UMIN000003784.

KW - Alpha-glucosidase inhibitor

KW - Dipeptidyl peptidase 4 (DPP-4) inhibitors

KW - LV diastolic function

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DO - 10.1186/s12933-015-0242-z

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