title: Effect of vildagliptin add-on treatment to metformin on plasma asymmetric dimethylarginine in type 2 diabetes mellitus patients.
abstract: OBJECTIVE
  A close association has been demonstrated between increased cardiovascular risk and high asymmetric dimethylarginine (ADMA) levels in type 2 diabetes mellitus (DM) patients. We planned to measure serum ADMA levels in type 2 DM patients using vildagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor.
  
  
  METHODS
  A total of 68 type 2 DM patients who were on metformin were enrolled in the study. Based on the glycemic levels of patients, vildagliptin was added on to treatment in 33 patients. Patients were followed for 6 months. Serum ADMA, C-reactive protein, and fibrinogen levels were compared in groups of patients using metformin or metformin + vildagliptin, after 6 months.
  
  
  RESULTS
  Serum ADMA levels were found to be significantly lower in the group using vildagliptin compared to the group using metformin + vildagliptin (P<0.001). However, serum C-reactive protein and fibrinogen levels were statistically similar in the two study groups (P=0.34 and P=0.23, respectively).
  
  
  CONCLUSIONS
  Metformin + vildagliptin treatment was observed to lower serum ADMA levels in type 2 DM patients. Our findings notwithstanding, large-scale prospective randomized controlled studies are warranted to conclude that vildagliptin provides cardiovascular protection along with diabetes regulation.
authors.affiliation: Internal Medicine Clinic, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cakirca
authors.affiliation: Internal Medicine Clinic, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Cumali
authors.initials: C
authors.lastname: Karatoprak
authors.affiliation: Internal Medicine Clinic, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Zorlu
authors.affiliation: Internal Medicine Clinic, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Muharrem
authors.initials: M
authors.lastname: Kiskac
authors.affiliation: Department of Internal Medicine, Medical Faculty, Istanbul Medipol University, Istanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kanat
authors.affiliation: Internal Medicine Clinic, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Cikrikcioglu
authors.affiliation: Department of Geriatric Medicine, Medical Faculty, Dokuz Eylül University, Istanbul, Turkey.
authors.forename: Pinar
authors.initials: P
authors.lastname: Soysal
authors.affiliation: Department of Internal Medicine, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Hursitoglu
authors.affiliation: Internal Medicine Clinic, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Ahmet Adil
authors.initials: AA
authors.lastname: Camli
authors.affiliation: Internal Medicine Clinic, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Reha
authors.initials: R
authors.lastname: Erkoc
authors.affiliation: Division of Medicine - Diabetes, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Abdul-Ghani
mesh_terms: D000218:Adamantane / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood; D009570:Nitriles / Q000008:administration & dosage / Q000627:therapeutic use*; D011759:Pyrrolidines / Q000008:administration & dosage / Q000627:therapeutic use*; D000077597:Vildagliptin
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; D004338:Drug Combinations; D007004:Hypoglycemic Agents; D009570:Nitriles; D011759:Pyrrolidines; D009569:Nitric Oxide; C018524:N,N-dimethylarginine; D005340:Fibrinogen; D002097:C-Reactive Protein; D008687:Metformin; D001120:Arginine; D000077597:Vildagliptin; D000218:Adamantane
keywords: asymmetric dimethylarginine (ADMA); dipeptidyl peptidase-4 (DPP-4) inhibitor; type 2 diabetes mellitus; vildagliptin