title: Effect of sitagliptin on epicardial fat thickness in subjects with type 2 diabetes and obesity: a pilot study.
abstract: The aim of the study was to assess the effect of sitagliptin addition on the epicardial adipose tissue (EAT) thickness in subjects with type 2 diabetes mellitus inadequately controlled on metformin monotherapy. This was a 24-week interventional pilot study in 26 consecutive type 2 diabetic patients, 14 females and 12 males average age of 43.8 ± 9.0 years, with Hemoglobin A1c (HbA1c) ≥ 7% on metformin monotherapy. Subjects who met the inclusion criteria were added on sitagliptin and started on sitagliptin/metformin combination at the dosage of 50 mg/1000 mg twice daily. EAT and visceral and total body fat were measured, respectively, with echocardiography and bioelectrical impedance analysis at baseline and after 24 weeks of sitagliptin/metformin treatment in each subject. HbA1c and plasma lipids were also measured. EAT decreased significantly from 9.98 ± 2.63 to 8.10 ± 2.11 mm, p = 0.001, accounting for a percentage of reduction (∆%) of -15% after 24 weeks of sitagliptin addition, whereas total body fat percentage, visceral fat, and body mass index (BMI), decreased by 8, 12, and 7%, respectively (p = 0.001 for all). After 6 month, EAT ∆% was significantly correlated with ∆% of visceral fat (r = 0.456; p = 0.01), whereas no correlation with either BMI ∆% (r = 0.292; p = 0.147) or HbA1c ∆% was found. The addition of Sitagliptin produced a significant and rapid reduction of EAT, marker of organ-specific visceral fat, in overweight/obese individuals with type 2 diabetes inadequately controlled on metformin monotherapy. EAT as measured with ultrasound can serve as no invasive and accurate marker of visceral fat changes during pharmaceutical interventions targeting the fat.
authors.affiliation: Departamento de Ciencias Fisiológicas, Universidad de Oriente, Núcleo Bolívar, Ciudad Bolívar, Venezuela. marcoslimamedical@hotmail.com.|Anexo A Centro Médico Orinoco, Unidad de Endocrinología, Diabetes, Metabolismo y Nutrición, Ciudad Bolívar, Venezuela. marcoslimamedical@hotmail.com.
authors.forename: Marcos M
authors.initials: MM
authors.lastname: Lima-Martínez
authors.affiliation: Instituto Autónomo Hospital Universitario de los Andes, Unidad de Endocrinología, Mérida, Venezuela.
authors.forename: Mariela
authors.initials: M
authors.lastname: Paoli
authors.affiliation: Servicio de Cardiología, Hospital Universitario Ruíz y Páez, Ciudad Bolívar, Venezuela.
authors.forename: Marianela
authors.initials: M
authors.lastname: Rodney
authors.affiliation: Departamento de Ciencias Fisiológicas, Universidad de Oriente, Núcleo Bolívar, Ciudad Bolívar, Venezuela.|Anexo A Centro Médico Orinoco, Unidad de Endocrinología, Diabetes, Metabolismo y Nutrición, Ciudad Bolívar, Venezuela.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Balladares
authors.affiliation: Centro Médico El Valle, Nueva Esparta, Venezuela.
authors.forename: Miguel
authors.initials: M
authors.lastname: Contreras
authors.affiliation: Clínica Puerto Ordaz, Unidad Avanzada de Investigación y Diagnóstico Ecográfico y Renal (UNIRENAL), Ciudad Guayana, Venezuela.
authors.forename: Luis
authors.initials: L
authors.lastname: D'Marco
authors.affiliation: Division of Endocrinology, Department of Medicine, University of Miami Miller School of Medicine, Miami, USA.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Iacobellis
mesh_terms: D000273:Adipose Tissue / Q000187:drug effects / Q000473:pathology*; D050154:Adiposity; D000293:Adolescent; D000328:Adult; D000368:Aged; D001823:Body Composition / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000473:pathology*; D004359:Drug Therapy, Combination; D017097:Electric Impedance; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology*; D008055:Lipids / Q000097:blood; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000473:pathology*; D010496:Pericardium / Q000187:drug effects / Q000473:pathology*; D010865:Pilot Projects; D000068900:Sitagliptin Phosphate / Q000494:pharmacology*; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D008055:Lipids; D008687:Metformin; D000068900:Sitagliptin Phosphate
keywords: Diet; Epicardial adipose tissue; Epicardial fat; Exercise; Sitagliptin