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American Journal of Cardiovascular Drugs

, Volume 13, Issue 6, pp 443–450 | Cite as

Association Between Urinary Albumin Excretion and Low-density Lipoprotein Heterogeneity Following Treatment of Type 2 Diabetes Patients with the Dipeptidyl Peptidase-4 Inhibitor, Vildagliptin: A Pilot Study

  • Shigemasa TaniEmail author
  • Ken Nagao
  • Atsushi Hirayama
Short Communication

Abstract

Background

Few data exist as to whether dipeptidyl peptidase (DPP)-4 inhibitors affect cardio-renal interaction, which is a strong independent prognostic factor for cardiovascular disease (CVD), in diabetic patients. We evaluated the effects of a DPP-4 inhibitor on atherogenic low-density lipoprotein (LDL) heterogeneity and albuminuria in diabetics as an indicator of the severity of diabetic nephropathy.

Methods

Type 2 diabetes patients (n = 47) inadequately controlled with diabetes therapy were treated with vildagliptin 50 mg bid for 8 weeks. LDL heterogeneity was evaluated on the basis of the patients’ small dense (sd) LDL levels and sd-LDL proportion (sd-LDL/LDL cholesterol [LDL-C]). The level of albuminuria was evaluated on the basis of the urinary albumin-to-creatinine ratio (UACR).

Results

After 8 weeks of treatment, there was no significant change in serum LDL-C level, but the serum sd-LDL level had decreased significantly by 8.8 %, and the UACR had also decreased significantly by 44.6 %. Triglyceride (TG)-metabolism-related markers (TG, remnant-like particle cholesterol, apolipoprotein [apo] B, apoC-2, and apoC-3) had decreased significantly. The Δ (absolute change from baseline) sd-LDL values correlated positively with ΔTG-metabolism-related markers, but not with the Δ hemoglobin (Hb) A1c or Δ fasting blood sugar (ΔFBS). Furthermore, multivariate regression analysis revealed that Δsd-LDL proportion, but not ΔHbA1c or ΔFBS, was an independent predictor of ΔUACR (β = 0.292, p = 0.0016).

Conclusions

Although this was a single-arm study, treatment of type 2 diabetes with vildagliptin might prevent the progression of CVD complicating diabetes by improving LDL heterogeneity, and it might improve renal function by decreasing albuminuria. A randomized controlled trial is warranted.

Keywords

Diabetic Nephropathy Sitagliptin Urinary Albumin Excretion Vildagliptin Vildagliptin Treatment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflict of interest

All the authors declare that they have no competing interests.

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Copyright information

© Springer International Publishing Switzerland 2013

Authors and Affiliations

  1. 1.Department of CardiologySurugadai Nihon University HospitalTokyoJapan
  2. 2.Division of Cardiology, Department of MedicineNihon University School of MedicineTokyoJapan

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