Effects Of Sitagliptin On Endothelial Function In Newly Diagnosed Type2Diabetes Mellitus Patients And Possible Mechanisms

Objective:To identify the effect of sitagliptin therapy on endothelial function in newly diagnosed type2diabetes mellitus (T2DM),and explore the possible mechanism.Methods:48newly diagnosed T2DM patients with HbAlc from6.5%to10.0%were selected randomly in endocrinology department of Xiang Ya hospital during July2012to January2013.All patients were treated with sitagliptin100mg/d for12weeks. The FMD and serum NO,3-NT, PAI-1were inspected at baseline and after12weeks of sitagliptin therapy.20age-and BMI-matched health examination people were selected as NC group during the same time. ELISA was used to detect serum NO, and3-NT PAI-1;High-resolution ultrasound was used to detect FMD. ALL the results were collected and analyzed by SPSS18.0.Results:1.FMD,NO were significantly decreased and3-NT, PAI-lwere significantly increased in DM group compared with control (p<0.01);2.FMD,NO were significantly increased and PAI-1were significantly decreased after sitagliptin therapy in DM group(p<0.01);3. Linear correlation analysis of the change of FMD with the change of3-NT、PAI-1、 NO and other indexes associated:ΔFMD had positive relation with ΔNO (P<0.01).4. Multiple linear regression of ΔFMD and the change of other risk factors associated:ΔFMD=0.531+0.041Δ NO-0.096ΔHOMA-IR.Conclusions:1. There were obvious oxidative stress, abnormal fibrinolytic activity and endothelial dysfunction in newly diagnosed T2DM, and endothelial dysfunction is closely related to these factors.2.vascular endothelial dysfunction of type2diabetes mellitus patients can be improved by the treatment with sitagliptin as evidenced by increase in the FMD, and improvement of the NO levels3. The improvement of abnormal fibrinolytic activity, insulin resistance and blood pressure after sitagliptin therapy can ameliorates endothelial dysfunction of newly diagnosed T2DM, but its possible mechanism is via increasing NO release.