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


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).
Division of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Hiroyasu
H
Uzui
Division of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Akira
A
Nakano
Division of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Yasuhiko
Y
Mitsuke
Division of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Toru
T
Geshi
Division of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Junji
J
Sakata
Division of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Katsuhiko
K
Sarazawa
Division of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Tetsuji
T
Morishita
Division of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Takehiko
T
Satou
Division of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Kentarou
K
Ishida
Division of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Jong-Dae
JD
Lee
Arterial stiffness; Matrix metalloproteinases; Postprandial hyperglycemia