Background
Methods
Study design
Study population
Echocardiographic examination
Laboratory examination
Variables | Baseline | 24 months | Least square means of baseline-adjusted changes | ||||||
---|---|---|---|---|---|---|---|---|---|
Sitagliptin (n = 55) | Conventional (n = 60) | p value | Sitagliptin (n = 55) | Conventional (n = 60) | p value | Sitagliptin (n = 55) | Conventional (n = 60) | p value | |
Age, year | 69 ± 8 | 69 ± 9 | 0.973 | ||||||
Gender (male/female) | 38/17 | 39/21 | 0.641 | ||||||
Body mass index, kg/m2
| 25.9 ± 3.3 | 24.8 ± 3.9 | 0.098 | 25.5 ± 3.4 | 24.6 ± 3.8 | 0.203 | −0.10 ± 0.16 | −0.13 ± 0.15 | 0.368 |
Systolic BP, mmHg | 132 ± 17 | 129 ± 19 | 0.287 | 133 ± 16 | 130 ± 20 | 0.377 | 1.70 ± 2.20 (n = 54) | 0.34 ± 2.09 | 0.656 |
Diastolic BP, mmHg | 74 ± 11 | 71 ± 12 | 0.090 | 75 ± 13 (n = 54) | 71 ± 11 | 0.076 | 1.76 ± 1.47 (n = 54) | −0.54 ± 1.40 | 0.263 |
Heart rate, beats/min | 70 ± 12 | 67 ± 12 | 0.196 | 71 ± 16 | 67 ± 10 | 0.129 | 3.37 ± 1.49 | −2.14 ± 1.43 | 0.009 |
Total cholesterol, mmol/L | 4.4 ± 0.8 | 4.6 ± 0.9 | 0.43 | 4.4 ± 0.8 (n = 54) | 4.4 ± 1.0 | 0.690 | −0.08 ± 0.09 (n = 54) | −0.10 ± 0.08 | 0.899 |
HDL cholesterol, mmol/L | 1.3 ± 0.3 (n = 55) | 1.4 ± 0.4 (n = 58) | 0.617 | 1.3 ± 0.3 (n = 54) | 1.4 ± 0.4 | 0.412 | −0.03 ± 0.03 (n = 54) | 0.00 ± 0.03 (n = 58) | 0.362 |
Triglycerides, mmol/L | 3.1 [2.2–4.5] (n = 54) | 3.1 [2.3–4.2] | 0.536 | 2.9 [2.2–5.0] (n = 54) | 2.9 [2.1–3.9] | 0.151 | 0.06 ± 0.06 (n = 53) | −0.08 ± 0.05 | 0.078 |
Creatinine, μmol/L | 71.6 [61.9–86.6] | 68.1 [59.2–89.3] | 0.496 | 75.1 [62.8–87.5] (n = 54) | 69.0 [61.0–98.1] | 0.740 | 2.65 ± 1.77 (n = 54) | 4.42 ± 1.77 | 0.345 |
eGFR, mL/min/1.73 m2
| 66.6 ± 15.9 | 67.3 ± 18.4 | 0.834 | 65.1 ± 14.1 (n = 54) | 67.1 ± 19.7 | 0.757 | −1.96 ± 1.10 (n = 54) | –3.18 ± 1.04 | 0.419 |
Fasting plasma glucose, mmol/L | 7.5 ± 1.8 (n = 53) | 7.1 ± 1.4 | 0.135 | 7.0 ± 1.6 (n = 54) | 6.7 ± 1.7 (n = 58) | 0.248 | −0.41 ± 0.20 (n = 52) | −0.49 ± 0.19 (n = 58) | 0.780 |
HbA1c, % | 7.0 ± 0.6 | 6.9 ± 0.5 | 0.737 | 6.5 ± 0.6 (n = 54) | 6.6 ± 0.7 | 0.412 | −0.47 ± 0.08 (n = 52) | −0.34 ± 0.07 (n = 57) | 0.211 |
1,5AG, µg/mL | 13.9 [8.3–20.3] (n = 52) | 15.6 [10.7–22.8] (n = 58) | 0.086 | 16.4 [8.7–22.6] | 15.1 [9.6–25.0] (n = 59) | 0.747 | 2.55 ± 0.82 (n = 52) | 0.95 ± 0.79 (n = 57) | 0.165 |
NT-proBNP, pg/mL | 111.5 [42.1–240.8] (n = 52) | 99.6 [52.1–234.9] (n = 58) | 0.848 | 114.5 [51.8–261.9] | 114.1 [60.2–323.8] (n = 59) | 0.673 | 0.09 ± 0.08 (n = 52) | 0.16 ± 0.08 (n = 57) | 0.535 |
High-sensitive CRP, ng/mL | 540 [279–1100] (n = 52) | 576 [236–1618] (n = 58) | 0.952 | 478 [232–1150] (n = 55) | 478 [199–1590] (n = 59) | 0.984 | −0.06 ± 0.16 (n = 52) | −0.06 ± 0.15 (n = 57) | 0.983 |
Current smoker, n (%) | 8 (17.4) (n = 46) | 13 (28.3) (n = 46) | 0.321 | ||||||
Hypertension, n (%) | 45 (81.8) | 46 (76.7) | 0.497 | ||||||
Dyslipidemia, n (%) | 42 (76.4) | 42 (70.0) | 0.530 | ||||||
Cerebrovascular disease, n (%) | 8 (14.6) | 4 (6.7) | 0.226 | ||||||
Cardiovascular disease, n (%) | 38 (69.1) | 41 (68.3) | 0.930 | ||||||
Chronic heart failure, n (%) | 3 (5.5) | 7 (11.7) | 0.326 | ||||||
Medications | |||||||||
ACE inhibitor or ARB | 37 (67.3) | 42 (70.0) | 0.753 | 39 (70.9) | 41 (68.3) | 0.764 | |||
β-blocker | 12 (21.8) | 11 (18.3) | 0.641 | 13 (23.6) | 12 (20.0) | 0.637 | |||
Diuretic | 17 (30.9) | 12 (20.0) | 0.178 | 16 (29.1) | 15 (25.0) | 0.621 | |||
Statin | 42 (76.4) | 40 (66.7) | 0.251 | 39 (70.9) | 39 (65.0) | 0.498 | |||
α-Glucosidase inhibitor, n (%) | 23 (41.8) | 30 (50.0) | 0.455 | 18 (32.7) | 38 (63.3) | 0.001 | |||
Glinide, n (%) | 4 (7.3) | 4 (6.7) | 0.899 | 2 (3.6) | 5 (8.3) | 0.293 | |||
Biguanide, n (%) | 9 (16.4) | 10 (16.7) | 0.965 | 12 (21.8) | 16 (26.7) | 0.545 | |||
Sulfonylurea, n (%) | 9 (16.4) | 12 (20.0) | 0.638 | 4 (7.3) | 18 (30.0) | 0.002 | |||
Thiazolidinedione, n (%) | 11 (20.0) | 18 (30.0) | 0.283 | 9 (16.4) | 23 (38.3) | 0.009 |
Statistical analysis
Results
Clinical characteristics
Glycemic control and neurohumoral effects
Echocardiographic parameters
Variables | Baseline | 24 months | Least square means of baseline-adjusted changes | ||||||
---|---|---|---|---|---|---|---|---|---|
Sitagliptin (n = 55) | Conventional (n = 60) | p value | Sitagliptin (n = 55) | Conventional (n = 60) | p value | Sitagliptin (n = 55) | Conventional (n = 60) | p value | |
TMF-E, cm/s | 74.2 ± 32.6 | 69.3 ± 31.0 | 0.417 | 73.1 ± 33.4 | 73.6 ± 34.3 | 0.939 | −0.85 ± 2.37 | 4.04 ± 2.27 | 0.139 |
e′, cm/s | 6.35 ± 1.72 | 7.03 ± 2.13 | 0.065 | 6.60 ± 2.19 | 6.76 ± 2.11 | 0.684 | 0.13 ± 0.23 | −0.16 ± 0.22 | 0.370 |
E/e′ | 12.17 ± 5.20 | 10.34 ± 4.18 | 0.040 | 12.19 ± 6.93 | 12.06 ± 7.06 | 0.922 | −0.18 ± 0.55 | 1.91 ± 0.53 | 0.008 |
TMF-A, cm/s | 80.1 ± 20.3 (n = 48) | 83.4 ± 21.3 (n = 54) | 0.424 | 82.4 ± 19.3 (n = 48) | 88.2 ± 22.9 (n = 55) | 0.168 | 3.06 ± 2.10 (n = 47) | 5.73 ± 1.96 (n = 54) | 0.354 |
E/A | 0.91 ± 0.52(n = 48) | 0.79 ± 0.24 (n = 54) | 0.125 | 0.86 ± 0.35 (n = 48) | 0.81 ± 0.31 (n = 54) | 0.418 | −0.03 ± 0.04 (n = 48) | −0.04 ± 0.04 (n = 54) | 0.825 |
Deceleration time, msec | 233.5 ± 65.8 (n = 50) | 237.6 ± 67.7 (n = 55) | 0.751 | 238.1 ± 78.1 (n = 52) | 240.6 ± 64.6 (n = 58) | 0.859 | 9.53 ± 9.06 (n = 49) | 5.38 ± 8.63 (n = 54) | 0.741 |
LV end-diastolic dimension, mm | 48.5 ± 5.6 | 48.6 ± 5.9 | 0.912 | 47.5 ± 5.7 | 47.7 ± 5.3 | 0.836 | −1.04 ± 0.51 | −0.91 ± 0.48 | 0.855 |
LV end-systolic dimension, mm | 31.7 ± 6.1 | 32.6 ± 7.2 | 0.462 | 31.5 ± 7.1 | 31.6 ± 6.9 | 0.935 | −0.30 ± 0.60 | −0.94 ± 0.58 | 0.447 |
Fractional shortening, % | 35.1 ± 6.7 | 33.6 ± 7.9 | 0.279 | 33.9 ± 13.3 | 34.4 ± 8.5 | 0.787 | −1.05 ± 1.31 | 0.64 ± 1.25 | 0.355 |
LV ejection fraction, % | 63.6 ± 9.6 | 60.8 ± 10.8 | 0.153 | 62.5 ± 9.3 | 61.9 ± 9.8 | 0.721 | −0.63 ± 0.85 (n = 54) | 0.67 ± 0.81 | 0.273 |
LV mass, g | 173.0 ± 66.6 | 160.2 ± 56.3 | 0.266 | 159.9 ± 49.1 | 159.2 ± 52.9 | 0.940 | −10.29 ± 4.94 | −3.50 ± 4.73 | 0.324 |
LV mass index, g/m2
| 101.6 ± 35.0 | 96.2 ± 30.6 | 0.383 | 94.8 ± 26.3 | 95.6 ± 28.3 | 0.881 | −5.50 ± 2.81 | −1.80 ± 2.68 | 0.343 |
Relative wall thickness | 0.40 ± 0.09 | 0.38 ± 0.08 | 0.230 | 0.41 ± 0.08 | 0.39 ± 0.08 | 0.400 | 0.01 ± 0.01 | 0.00 ± 0.01 | 0.886 |
LA dimension, mm | 40.8 ± 6.9 (n = 54) | 40.0 ± 7.6 (n = 58) | 0.572 | 39.7 ± 6.9 | 40.3 ± 6.9 (n = 59) | 0.652 | −0.87 ± 0.55 (n = 54) | 0.25 ± 0.54 (n = 58) | 0.151 |
Model 1 | Model 2 | Model 3 | ||||
---|---|---|---|---|---|---|
N = 115, R = 0.26 | N = 115, R = 0.27 | N = 115, R = 0.55 | ||||
β | p value | β | p value | β | p value | |
Sitagliptin | −8.910 | 0.006 | −8.887 | 0.007 | −9.959 | 0.001 |
E/e′ | −0.094 | 0.889 | −0.159 | 0.820 | −0.240 | 0.716 |
Male gender | 0.674 | 0.845 | 0.149 | 0.966 | ||
Age | 0.330 | 0.392 | −0.005 | 0.990 | ||
Systolic blood pressure | −0.293 | 0.095 | ||||
HbA1c | 6.614 | 0.272 | ||||
Cardiovascular disease | −5.631 | 0.142 | ||||
Chronic heart failure | 10.819 | 0.070 | ||||
α-glucosidase inhibitor | 1.053 | 0.734 | ||||
Biguanide | −14.839 | 0.001 | ||||
Glinide | −10.778 | 0.072 | ||||
Sulfonylurea | −0.567 | 0.891 | ||||
Thiazolidinedione | 2.159 | 0.572 | ||||
LV ejection fraction | 0.178 | 0.602 | ||||
LV mass index | 0.348 | <0.001 |