title: Effect of dipeptidyl peptidase-4 inhibitor, vildagliptin on plasminogen activator inhibitor-1 in patients with diabetes mellitus.
abstract: Dipeptidyl peptidase-4 (DPP-4) inhibitors may affect the serum levels of plasminogen activator inhibitor-1 (PAI-1) associated with triglyceride (TG) metabolism, which is a prognostic factor for cardiovascular disease, in diabetic patients. We conducted an 8-week, prospective, randomized study in which we assigned type 2 diabetic patients who were inadequately controlled with antidiabetic therapy to the vildagliptin group (50 mg bid, n = 49) or the control group (n = 49). The primary efficacy parameter was the change in the serum level of PAI-1, and the secondary end point was the change in the serum levels of TG-rich lipoproteins. In the vildagliptin group, significant decrease of the serum PAI-1 level by 16.3% (p <0.0001) and significant decreases of the serum TG, remnant-like particle cholesterol, and apolipoprotein B levels by 12.1% (p = 0.002), 13.9% (p = 0.003), and 9.5% (p <0.0001), respectively, were observed. No such changes were observed in the control group. Multivariate regression analyses identified the absolute change from the baseline (Δ) of the PAI-1, but not that of the fasting blood glucose or hemoglobin A1c, as independent predictors of the ΔTG, Δ remnant-like particle cholesterol, and Δ apolipoprotein B. In conclusion, treatment of type 2 diabetes with vildagliptin might prevent the progression of atherosclerotic cardiovascular disease in diabetic patients by decreasing the serum PAI-1 levels and improving TG metabolism.
authors: Department of Health Planning Center, Nihon University Hospital, Tokyo Japan; Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo Japan. Electronic address: tani.shigemasa@nihon-u.ac.jp.
authors: Shigemasa
authors: S
authors: Tani
authors: Department of Health Planning Center, Nihon University Hospital, Tokyo Japan; Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo Japan.
authors: Atsuhiko
authors: A
authors: Takahashi
authors: Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo Japan.
authors: Ken
authors: K
authors: Nagao
authors: Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo Japan.
authors: Atsushi
authors: A
authors: Hirayama
mesh_terms: D000218:Adamantane / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009570:Nitriles / Q000008:administration & dosage*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D011446:Prospective Studies; D011759:Pyrrolidines / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome; D000077597:Vildagliptin
chemical_list: D000218:Adamantane; D001786:Blood Glucose; D054873:Dipeptidyl-Peptidase IV Inhibitors; D006442:Glycated Hemoglobin; D009570:Nitriles; D017395:Plasminogen Activator Inhibitor 1; D011759:Pyrrolidines; D000077597:Vildagliptin