Acarbose treatments improve arterial stiffness in patients with type 2 diabetes mellitus

Abstract

Aims/Introduction: Although the improvement of postprandial hyperglycemia by an alpha‐glucosidase inhibitor (α‐GI) has been associated with a risk reduction of cardiovascular events, the relationship between postprandial hyperglycemia and arterial stiffness has not been well understood. We therefore examined whether ameliorating the postprandial state by α‐GI leads to an improvement in arterial stiffness.Materials and Methods: A total of 22 patients with type 2 diabetes mellitus were treated with acarbose. Cardio‐ankle vascular index (CAVI) as the arterial stiffness was measured by using a VaSera CAVI instrument before and 12 months after acarbose treatment. Serum high‐sensitivity C‐reactive protein (hs‐CRP), pentraxin‐3 (PTX3) and matrix metalloproteinase (MMP) ‐2, ‐9 were measured at the same time points. Furthermore, circulating peripheral blood mononuclear cells were examined for the frequencies of CD14 positive cells expressing membrane type‐1 MMP (MT1‐MMP) at the single cell level using flow cytometry.Results: After acarbose treatment, postprandial glucose and glycosylated hemoglobin (HbA1c) were significantly decreased. Serum levels of hs‐CRP, PTX3, MMP‐2 and MMP‐9 were significantly decreased. CAVI showed a significant reduction, although the changes were not significant in blood pressure and heart rate. MT1‐MMP expression was significantly decreased by acarbose treatment. In multivariate analysis, improvement of blood glucose, decrease of PTX3 levels and MT1‐MMP expression were independent predictors of beneficial change in CAVI.Conclusions: The present study showed that the beneficial effects of acarbose on arterial stiffness are mediated by an improvement of postprandial hyperglycemia and vascular remodeling markers. In conclusion, acarbose treatment might reduce the risk of cardiovascular diseases by altering the arterial stiffness in postprandial hyperglycemic status. (J Diabetes Invest, doi:10.1111/j.2040‐1124.2010.00079.x, 2010)

Pulse wave analysis and diabetes mellitus. A systematic review

“…Acarbose treatment reduces the risk of cardiovascular disease by altering the arterial stiffness in the postprandial hyperglycaemic status in patients with type 2 diabetes. In this study a significant reduction in cardio-ankle vascular index (a parameter of arterial stiffness) was shown, although the changes in blood pressure and heart rate were not significant 84 . 86 .…”

The Role of a Novel Arterial Stiffness Parameter, Cardio-Ankle Vascular Index (CAVI), as a Surrogate Marker for Cardiovascular Diseases

“…The values of CAVI are sometimes influenced by the glucose-lowering treatment; there are some glucoselowering treatments that lower CAVI and others that do not 65) . Alpha-glucosidase inhibitor, acarbose, reduces CAVI mediated by an improvement of postprandial hyperglycemia 66) . Ohira et al 67) reported that switching biphasic insulin from human insulin 30/70 to insulin aspart 30/70 improved CAVI together with the marker of postprandial hyperglycemia.…”

Factors associated with abnormal cardio-ankle vascular index in patients with type 2 diabetes and prediabetes

“…Так, отмечается независимая ассоциация CAVI с постпрандиальной гликемией [23,24], с уровнем гликированного гемоглобина (HbA 1c ) [9,19]. Кроме того, снижение HbA 1c на фоне компенсации СД существенно коррелировало с улучшением значений CAVI [9].…”

“…Кроме того, снижение HbA 1c на фоне компенсации СД существенно коррелировало с улучшением значений CAVI [9]. В лите-ратуре отмечено влияние длительного приема различных препаратов на снижение CAVI [23,24,25].…”

“…При этом отмечено существенное снижение CAVI, а при многофакторном анализе -снижение уровня глю-козы в крови, PTX3 и экспрессии MT1-MMP были не-зависимыми предикторами благоприятных изменений CAVI [23]. Изменение схемы лечения больных СД может дополнительно сказаться на улучшении показателей со-судистой жесткости.…”