title: Vildagliptin reduces plasma stromal cell-derived factor-1α in patients with type 2 diabetes compared with glimepiride.
abstract: OBJECTIVE
  Dipeptidyl peptidase-4 inhibitors might have pleiotropic protective effects on cardiovascular disease (CVD), in contrast to sulfonylureas. Therefore, we compared various CVD risk factors between vildagliptin and glimepiride.
  
  
  METHODS
  We carried out a randomized, prospective and crossover trial. A total of 16 patients with type 2 diabetes whose glycated hemoglobin was >7% were randomized to add vildagliptin or glimepiride. After 12-week treatment, each drug was replaced with the other for another 12 weeks. Before and after each treatment, glucose homeostasis and CVD risk factors were assessed, and the continuous glucose monitoring system was applied to calculate glycemic variability.
  
  
  RESULTS
  The mean age of the participants was 60 years, 31% were men, body mass index 25.5 kg/m2and HbA1c 8.41%. Both vildagliptin and glimepiride significantly decreased glycated hemoglobin and glycemic variability indices. Despite the improved glucose homeostasis, favorable change of CVD markers was not prominent in both the arms, along with significant weight gain. Only plasma stromal cell-derived factor (SDF)-1α decreased by 30% in the vildagliptin arm. According to regression analyses, the reduction of SDF-1α was independently associated with vildagliptin usage and serum interleukin-6 changes, but white blood cells were not related with the SDF-1α changes.
  
  
  CONCLUSIONS
  Compared with glimepiride, vildagliptin arrestingly decreased plasma SDF-1α, and its clinical implications should be further investigated.
authors: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors: Kyeong Seon
authors: KS
authors: Park
authors: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors: SooHeon
authors: S
authors: Kwak
authors: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors: Young Min
authors: YM
authors: Cho
authors: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors: Kyong Soo
authors: KS
authors: Park
authors: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Korea.
authors: Hak C
authors: HC
authors: Jang
authors: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors: Seong Yeon
authors: SY
authors: Kim
authors: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors: Hye Seung
authors: HS
authors: Jung
mesh_terms: D000218:Adamantane / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications / Q000517:prevention & control*; D054377:Chemokine CXCL12 / Q000097:blood*; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009570:Nitriles / Q000627:therapeutic use*; D011446:Prospective Studies; D011759:Pyrrolidines / Q000627:therapeutic use*; D012307:Risk Factors; D013453:Sulfonylurea Compounds / Q000627:therapeutic use*; D000077597:Vildagliptin
chemical_list: D000218:Adamantane; D054377:Chemokine CXCL12; D054873:Dipeptidyl-Peptidase IV Inhibitors; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D009570:Nitriles; D011759:Pyrrolidines; D013453:Sulfonylurea Compounds; D000077597:Vildagliptin; C515255:CXCL12 protein, human; C517652:hemoglobin A1c protein, human; C057619:glimepiride
keywords: Cardiovascular risk; Stromal cell-derived factor-1α; Vildagliptin