EYES2019 7th ESE Young Endocrinologists and Scientists (EYES) Meeting Oral Presentations (67 abstracts)
Effects of novel antidiabetic agents on the arterial wall elastic properties as a marker of vascular function in patients with type 2 diabetes mellitus
Panagiota Stampouloglou 1 , Gerasimos Siasos 1 , Evanthia Bletsa 1 , Konstantinos Batzias 1 , Stavroula A Paschou 1 , Alexis Antonopoulos 1 , Vasiliki Tsigkou 1 , Evangelos Oikonomou 1 , Nikolaos Gouliopoulos 1 , Anastasia Thanopoulou 2 , Marina Noutsou 2 , Andromahi Vryonidou 3 , Nikolaos Tentolouris 4 & Dimitris Tousoulis 1
11st Department of Cardiology, Hippokration General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; 2Diabetes Center, Second Department of Internal Medicine, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; 3Department of Endocrinology and Diabetes, Hellenic Red Cross Hospital, Athens, Greece; 4Diabetes Center, First Department of Propaedeutic Internal Medicine, Laiko Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Background: Arterial stiffness is a well-established surrogate marker of vascular properties and arterial dysfunction in patients with type 2 diabetes mellitus (DM2). We aimed to investigate whether optimization of DM2 therapy with, additional to metformin, novel antiglycemic agents may improve arterial wall properties and achieve better glycemic control.
Methods: We enrolled 99 consecutive patients (male gender=63.3%) receiving metformin for DM2 who did not achieve therapeutic targets under current treatment. Subjects were assigned to age and sex matched equal groups (n=33 per group) of an additional antiglycemic agent; either dipeptidyl peptidase-4 inhibitor (DPP-4), sodium/glucose cotransporter-2 inhibitors (SGLT2) (n=28) or glucagon like peptide-1 (GLP-1) liraglutide. Applanation tonometry was used to assess non-invasively augmentation index (AIx) and aortic pulse wave velocity (PWV) as a measure of arterial stiffness at baseline and at 3-month follow-up. Among other demographics data, hemoglobin A1c (HbA1c) was measured.
Results: There was no difference for male gender (P=0.10) or age (64.92±8.30 years, P=0.27) between the 3 study groups. Interestingly, baseline values improved significantly after SGLT2 and DPP4 administration both for PWV (11.46±2.77 vs. 9.83±2.19 m/s and 10.89±2.35 vs. 9.68±1.77 m/s respectively, P=0.01 for both) and AIx (28.81±8.55 vs. 25.82±7.40 and 27.91±13.05 vs. 24.91±12.70 respectively, P=0.01 for both), when compared to those at follow-up time. In contrast, GLP-1 administration decreased PWV (12.82±3.00 m/s at baseline vs. 11.67±2.77 m/s during follow-up, P<0.001) but not AIx (31.64±6.21 vs. 30.18±6.03, P=0.18). HbA1c at baseline was uniformly decreased in all study groups when compared to follow-up (7.52% vs. 6.72% for SGLT2, 7.76% vs. 6.92% for DPP4 and 8.19% vs. 6.85% for GLP1, P<0.001 for all).
Conclusion: The optimization of DM2 treatment with SGLT-2, DPP4 or GLP1, added to metformin, not only helps to achieve better glycemic control but significantly ameliorates arterial stiffness indices and achieves therapeutic targets in patients with DM2.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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