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Effect of sitagliptin on epicardial fat thickness in subjects with type 2 diabetes and obesity: a pilot study

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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.

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Acknowledgments

The authors thank Ana Pensa and José Ledezma for their support, and Prof. Carlos Mota for his valuable comments to the manuscript.

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Authors and Affiliations

  1. Departamento de Ciencias Fisiológicas, Universidad de Oriente, Núcleo Bolívar, Ciudad Bolívar, Venezuela

    Marcos M. Lima-Martínez & Nathalie Balladares

  2. Anexo A Centro Médico Orinoco, Unidad de Endocrinología, Diabetes, Metabolismo y Nutrición, Ciudad Bolívar, Venezuela

    Marcos M. Lima-Martínez & Nathalie Balladares

  3. Instituto Autónomo Hospital Universitario de los Andes, Unidad de Endocrinología, Mérida, Venezuela

    Mariela Paoli

  4. Servicio de Cardiología, Hospital Universitario Ruíz y Páez, Ciudad Bolívar, Venezuela

    Marianela Rodney

  5. Centro Médico El Valle, Nueva Esparta, Venezuela

    Miguel Contreras

  6. Clínica Puerto Ordaz, Unidad Avanzada de Investigación y Diagnóstico Ecográfico y Renal (UNIRENAL), Ciudad Guayana, Venezuela

    Luis D’Marco

  7. Division of Endocrinology, Department of Medicine, University of Miami Miller School of Medicine, Miami, USA

    Gianluca Iacobellis

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  1. Marcos M. Lima-Martínez
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Correspondence to Marcos M. Lima-Martínez.

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Lima-Martínez, M.M., Paoli, M., Rodney, M. et al. Effect of sitagliptin on epicardial fat thickness in subjects with type 2 diabetes and obesity: a pilot study. Endocrine 51, 448–455 (2016). https://doi.org/10.1007/s12020-015-0710-y

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