الفهرس | Only 14 pages are availabe for public view |
Abstract T2DM is a complex progressive disease with life-threatening complications and one of the most serious public-health problems worldwide due to the rapidly increasing prevalence worldwide. Hyperglycemia, insulin resistance, hyperinsulinemia and hyperlipidemia represent important pathophysiological components of DM that result in ED through several underlying processes. ED is regarded as an important factor in the pathogenesis of vascular disease in DM. New therapies based on the incretin hormone and its actions are now becoming widely used, and appear to offer advantages over conventional therapies. Sitagliptin, one of the DPP4 inhibitors, target the incretin hormones provoking glucose-dependent insulin secretion from the pancreas and improve HbA1c levels when compared with metformin, sulfonylureas or glitazones without contributing to weight gain and hypoglycemia. Caution is required when choosing the sitagliptin in people with renal or hepatic impairment and with a risk of pancreatitiso It was found that patients with newly diagnosed T2DM (pre-treatment with sitagliptin) had statisticallysignificant lower FMD than healthy controls .There was significant reduction in SBP and DBP after sitagliptin treatment. However, there was statistically insignificant difference in BMI and WC before and after treatment.Sitagliptin significantly reduced FBG, PPBG, HbA1c, ALT, TGs, TC, LDL and HOMA-IR. Whereas significantly increased the fasting insulin and HOMA-β but, no statistically significant change in HDL, amylase and lipase after treatment (it seems from this study that sitagliptin has no deleterious effect on the incidence of pancreatitis, however future long term studies are needed to evaluate this topic).Percentage of ED in patients with newly diagnosed T2DM was significantly decreased after treatment with sitagliptin. There was significant negative correlation between Δ FMD and Δ SBP, Δ FBG, Δ PPBG, Δ HbA1c, Δ insulin, Δ HOMA-IR, Δ TC, Δ TG and Δ LDL whereas there was positive correlation between Δ FMD and Δ HOMA-β. There was insignificant correlation between Δ FMD and Δ DBP, ΔWC, Δ BMI and Δ ALT. With multiple regression analysis, it was found that each of Δ TGs, Δ LDL, Δ HOMA-IR were negative independent predictors of ΔFMD (R2= 0.461).Sitagliptin seems to be effective not only on glycemic control and insulin resistance but, also improving ED, SBP and dyslipidemia, it was found to have a neutral effect on body weight. |