Effect of vildagliptin versus glibenclamide on endothelial function and arterial stiffness in patients with type 2 diabetes and hypertension: a randomized controlled trial

Cosenso-Martin, Luciana Neves; Giollo-Júnior, Luiz Tadeu; Fernandes, Leticia Aparecida Barufi; Cesarino, Cláudia Bernardi; Nakazone, Marcelo Arruda; Machado, Maurício de Nassau; Vilela-Martin, José Fernando

doi:10.1007/s00592-018-1204-1

Cited by 22 publications

(22 citation statements)

References 50 publications

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“…Some of us have previously shown that metformin did not affect significantly PWV over a period of 6 months in drug‐naïve patients with T2DM, while in a recently published sub‐analysis of the Maastricht Study, it was demonstrated that metformin use did not feature a significant impact on aortic stiffness . As far as sulphonylureas are concerned, it has been previously shown that glibenclamide does not affect augmentation index, compared to sitagliptin; however, in a more recent RCT it was demonstrated that glibenclamide significantly decreased ambulatory PWV after 12 weeks of treatment, although the effect was not significant when compared to vildagliptin . Regarding pioglitazone, existing evidence might be considered as old and limited; however, its significant effect on aortic stiffness has also been shown in a non‐diabetic population, namely in patients with rheumatoid arthritis …”

Section: The Effect Of Other Antidiabetics On Arterial Stiffnessmentioning

confidence: 96%

Prognostic value of arterial stiffness measurements in cardiovascular disease, diabetes, and its complications: The potential role of sodium‐glucose co‐transporter‐2 inhibitors

Patoulias

Papadopoulos

Stavropoulos

et al. 2020

J of Clinical Hypertension

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Type 2 diabetes mellitus (T2DM) constitutes a global pandemic, representing the 7th cause of death worldwide. Morbidity and mortality of patients with T2DM are gradually increasing, while prevalence of cardiovascular disease (CVD) among these patients is almost 14% greater compared to the general population. Arterial stiffness is nowadays a valuable biomarker of CVD and a promising treatment target in specific patient groups, including those suffering from T2DM. Despite that fact, design of the available studies cannot prove causal relationship. Recently, a new antidiabetic drug class, namely sodium-glucose co-transporter-2 (SGLT-2) inhibitors, has attracted scientific interest, due to their multiple, beneficial, pleiotropic effects, especially those focused on CVD. There is limited relevant literature concerning the effects of SGLT-2 inhibitors on arterial stiffness, while retrieved results might be considered as conflicting. The aim of the present review article is to summarize acquired knowledge regarding the prognostic role of arterial stiffness in T2DM, along with the presentation of retrieved data on the potential role of SGLT-2 inhibitors. | 563 PATOULIAS eT AL.

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Section: The Effect Of Other Antidiabetics On Arterial Stiffnessmentioning

confidence: 96%

Prognostic value of arterial stiffness measurements in cardiovascular disease, diabetes, and its complications: The potential role of sodium‐glucose co‐transporter‐2 inhibitors

Patoulias

Papadopoulos

Stavropoulos

et al. 2020

J of Clinical Hypertension

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show abstract

“…A total of 148 participants were invited to participate in this trial, 50 met the criteria for inclusion and were randomly assigned to the present study, as described in a previous study. 13 According to previous publication, no differences were described between the groups with respect to age, duration of T2DM or hypertension, office BP level, body mass index (BMI), HbA1c level, eGFR, lipid parameters, and microalbuminuria ( Table 1 ).…”

Section: Resultsmentioning

confidence: 94%

“…doi:10.1007/s00592-018-1204-1, COPYRIGHT (2018). 13 Abbreviations: BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; FG, fasting glucose; TC, total cholesterol; LDLc, low-density lipoprotein cholesterol; HDLc, high-density lipoprotein cholesterol; TG, triglycerides; eGFR, estimated glomerular filtration rate; UA/Cr, urinary albumin-to-creatinine ratio. …”

Section: Resultsmentioning

confidence: 99%

“… 11 , 12 According to a previous study, vildagliptin and glibenclamide similarly have no effect on endothelial function and arterial stiffness in diabetic and hypertensive patients without cardiovascular events. 13 Moreover, three large multicenter trials testing saxagliptin, alogliptin and sitagliptin failed to demonstrate benefits of the DPP-4 inhibitors on the cardiovascular system. 14 – 16 …”

Section: Introductionmentioning

confidence: 99%

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<p>Randomized Study Comparing Vildagliptin vs Glibenclamide on Glucose Variability and Endothelial Function in Patients with Type 2 Diabetes Mellitus and Hypertension</p>

Cosenso-Martin¹,

Takaoka²,

Vilela-Martin³

2020

DMSO

Self Cite

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Background Glucose variability (GV) is considered an important factor for cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM). High GV causes endothelial dysfunction and increased oxidative stress. Dipeptidyl peptidase-4 (DPP-4) inhibitors may improve endothelial function and decrease GV. The aim of this study was to investigate the effects of vildagliptin, a DPP-4 inhibitor, compared with glibenclamide in GV and endothelial function in patients with T2DM and arterial hypertension. Methods This is a prospective, randomized, open and drug-controlled study. Fifty patients older than 35 years with T2DM and hypertension without CVD were randomized to receive vildagliptin (n=25) or glibenclamide (n=25), both in added-on metformin. Laboratory tests and analysis of endothelial function were performed before and 12 weeks after treatment. Endothelial function, defined by reactive hyperemia index (RHI), was analyzed by peripheral artery tonometry (endo-PAT2000). GV was evaluated by capillary glucose with intermittent monitoring device, six measurements per day, for three days, before and after treatment. The median of standard deviation (SD) of mean blood glucose (MBG) was used to evaluate GV. Results GV decreased in the vildagliptin group (35.2 to 30.7, P =0.037) but did not change with glibenclamide (37.6 to 37.5, P =0.765). Glycated hemoglobin was similar in both groups. MBG decreased only in glibenclamide group, without difference with vildagliptin group ( P =0.374). There were no changes in the RHI in both groups and there was no correlation between GV and RHI ( P =0.658). Conclusion Vildagliptin reduces GV; however, the action on endothelial function was not demonstrated. In addition, there was no correlation between GV and endothelial function.

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“…This might lead to in ated effect sizes. In addition, an interesting phenomenon was found: lowering BP and blood glucose using anti-hypertensive and anti-diabetic medications for weeks does not improve the RHI-measured ED [25][26][27][28] , but the short-term lowering of TG using feno brate could 29 , to some extent, do this. This signi es that high TG might be a more sensitive index, imposing a greater effect on the endothelium for a certain amount of time.…”

Section: Discussionmentioning

confidence: 99%

A Novel Use of Structural Equation Modeling to Examine Life-style and Cardio-metabolic Factors Associated With Micro-vascular Endothelial Dysfunction in Middle-aged Chinese Males

Miao

Zhou

et al. 2020

Preprint

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Objective: The present study aims to use structural equation modeling with multiple regression pathways to examine direct and indirect association of potential behavioral (diet, physical activity and sleep) and cardio-metabolic risk factors with micro-vascular endothelial dysfunction (ED) among middle-aged Chinese males.Methods: The study was conducted in 306 middle-aged Chinese males, who underwent a health checkup between 2018 and 2019. Data on life-style behavior factors (physical activity, diet pattern, sleep quality, and diet data underwent exploratory and confirmatory factor analysis [EFA and CFA] in advance) and cardio-metabolic risk factors referring to metabolic syndrome [blood pressure, triglyceride (TG), fasting blood glucose, high-density lipoprotein cholesterol and body mass index] were introduced into the structural equation model to examine interrelationship among these factors and their association with ED, as evaluated by the reactive hyperemia index (RHI). Results: Impaired ED defined by RHI <1.67 occurred in 39.2% of the participants. Both EFA and CFA identified two major dietary patterns: "prudent pattern" and "western pattern". The univariate test suggested that only TG and prudent dietary pattern were directly associated with RHI. Furthermore, prudent dietary pattern had a direct association with RHI (β=0.16, P<0.05) and an indirect association via triglyceride (Prudent diet→TG: β=-0.15, P<0.05; TG→RHI: β=-0.17, P<0.001). As to confirming the hypothesized association between variables apart, physical activity frequency was correlated to the decrease in TG (β=-0.29, P<0.001), but had no direct correlation to RHI.Conclusion: The network of direct and indirect associations among life-style behavioral and cardio-metabolic risk factors with RHI measured ED among middle-aged males. The most significant modifiable factors identified were TG and prudent diet pattern, which needs to be targeted as preventive strategies for early micro-vascular impairment.

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Effect of vildagliptin versus glibenclamide on endothelial function and arterial stiffness in patients with type 2 diabetes and hypertension: a randomized controlled trial

Abstract: ClinicalTrials.gov: NCT02145611, registered on 11 Jun 2013.

Cited by 22 publications

References 50 publications

Prognostic value of arterial stiffness measurements in cardiovascular disease, diabetes, and its complications: The potential role of sodium‐glucose co‐transporter‐2 inhibitors

Prognostic value of arterial stiffness measurements in cardiovascular disease, diabetes, and its complications: The potential role of sodium‐glucose co‐transporter‐2 inhibitors

<p>Randomized Study Comparing Vildagliptin vs Glibenclamide on Glucose Variability and Endothelial Function in Patients with Type 2 Diabetes Mellitus and Hypertension</p>

A Novel Use of Structural Equation Modeling to Examine Life-style and Cardio-metabolic Factors Associated With Micro-vascular Endothelial Dysfunction in Middle-aged Chinese Males

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