Effect of sitagliptin on epicardial fat thickness in subjects with type 2 diabetes and obesity: a pilot study
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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.
KeywordsEpicardial adipose tissue Epicardial fat Sitagliptin Diet Exercise
The authors thank Ana Pensa and José Ledezma for their support, and Prof. Carlos Mota for his valuable comments to the manuscript.
Compliance with ethical standards
Conflict of interest
The authors have no conflicts to disclose.
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