scholarly journals Sitagliptin on Carotid Intima-Media Thickness in Type 2 Diabetes Mellitus Patients and Anemia: A Subgroup Analysis of the PROLOGUE Study

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Zhengri Lu ◽  
Genshan Ma ◽  
Lijuan Chen
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Treatment Group ◽  
Conventional Treatment ◽  
Randomized Clinical Trials ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness

Introduction. Randomized clinical trials have not shown an additional clinical benefit of sitagliptin treatment over conventional treatment alone. However, studies of sitagliptin treatment have not examined the relationship between anemia and treatment group outcomes. Methods. The PROLOGUE study is a prospective clinical trial of 442 participants with type 2 diabetes mellitus (T2DM) randomized to sitagliptin treatment or conventional treatment which showed no treatment differences [Estimated mean (± standard error) common carotid intima-media thickness (CIMT) was 0.827±0.007 mm and 0.837±0.007 mm, respectively, with a mean difference of -0.009 mm (97.2% CI −0.028 to 0.011, p=0.309) at 24 mo of follow-up]. This is a post hoc subanalysis using data obtained from the PROLOGUE study; the study population was divided into anemic groups (n=94) and nonanemic group (n=343) based on hemoglobin level. And we analyzed for the changes in each CIMT parameter from baseline to 24 months in subgroups. Results. The treatment group difference in baseline-adjusted mean common carotid artery- (CCA-) IMT at 24 months was −0.003 mm (95% CI −0.022 to 0.015, p=0.718) in the nonanemic subgroup and −0.007 mm (95% CI −0.043 to 0.030, p=0.724) in the anemic subgroup. Although there were no significant differences in the other CIMT parameters between the treatment groups in the anemic subgroup, the changes in mean and max ICA-IMT at 24 months in the nonanemic subgroup were significantly lower in the sitagliptin group than the conventional group [−0.104 mm (95% CI −0.182 to −0.026), p=0.009 and −0.142 mm (−0.252 to −0.033), p=0.011, respectively]. Conclusion. These data suggest that nonanemia may indicate a potentially large subgroup of those with T2DM patients that sitagliptin therapy has a better antiatherosclerotic effect than conventional therapy. Further research is needed to confirm these preliminary observations.

scholarly journals Pengaruh Simvastatin Terhadap Ketebalan Intima-Media Karotis Pada Pasien Stroke Iskemik Dengan Diabetes Mellitus Tipe 2

2019 ◽  
Vol 6 (1) ◽  
pp. 20-23
Author(s):  
Aditya Kurnianto ◽  
Dodik Tugaswowo Pramukarso
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Ischemic Stroke ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
T Test ◽  
Stroke Patients ◽  
Media Thickness

BACKGROUND :Ischemic stroke is the most common stroke comprising 70-80% of all cases. Carotid intima-media thickness (CIMT) is associated with the occurrence of stroke in older age and adults. Patients with type 2 diabetes mellitus tend to develop a thickening of intima-media carotid artery. Simvastatins inhibit further atherothrombotic process. OBJECTIVE : To analyze the effect of simvastatin for CIMT in ischemic stroke patient with type 2 diabetes mellitus. METHOD : This study was a Randomized Pretest-Posttest Design and conducted at the Hospital Inpatient Ward Dr. Kariadi and Ketileng Semarang from January to December 2014 for all first ischemic stroke patients with Type 2 Diabetes Mellitus. Subjects were divided into groups of 26 controls and 28 patients treated groups. Treatment group were given simvastatin 20 mg each daily for 24 weeks in 28 subjects with a history of acute ischemic stroke and type 2 Diabetes mellitus. Examine the CIMT at the 1st week and 24th week. The normality of the data were tested using Shapiro Wilk and the differences analyzed by using Paired t-test and independent t test. RESULT : There was a significant differences between delta carotid intima-media thickness on administration of simvastatin for ischemic stroke patients with type 2 diabetes mellitus (p=0,008). CONCLUSION : Simvastatin significantly decreases CIMT on ischemic stroke patients with type 2 diabetes mellitus. Keyword : simvastatin, ischemic stroke, carotid intima-media thickness, type 2 diabetes mellitus   LATAR BELAKANG :Stroke iskemik memiliki angka insidensi terbanyak yaitu 70-80% kasus stroke. Ketebalan Intima-media karotis berhubungan dengan terjadinyastroke pada usia tua.Pasien dengan Diabetes mellitus tipe 2 memiliki kemungkinan yang lebih besar mengalami penebalan intima-media carotis. Simvatatin menghambat proses aterotrombosis. TUJUAN :Untuk menganalisis pengaruh simvastatin terhadap ketebalan intima-media karotis pada pasien stroke iskemik dengan diabetes mellitus tipe 2. METODE :Penelitian ini adalah dengan Randomized Pretest-Posttest Design dan telah dilakukan di Rawat Jalan RSUP dr. Kariadi dan poli saraf rawat jalan RSUD Kota Semarang mulai Januari sampai dengan Desember 2014 untuk semua pasien stroke iskemik pertama kali dengan diabetes mellitus tipe 2. Subjek dibagi menjadi kelompok kontrol 26 pasien dan kelompok perlakuan 28 pasien. Kelompok perlakuan diberi simvastatin 20 mg sehari selama 24 minggu pada 28 subjek stroke iskemik dengan  diabetes mellitus tipe 2. Pemeriksaan ketebalan intima-media karotis dilakukan pada minggu ke-1 dan minggu ke-24. Data kemudian di uji normalitasnya menggunakan Saphiro wilk, lalu di analisis menggunakan uji beda paired t testdan independent t test. HASIL :  Kelompok perlakuan didapatkan penurunan ketebalan tunika intima arteri karotis (0,395 + 0,46; p=0,514), KESIMPULAN : Pemberian simvastatin menurunkan ketebalan intima-media karotis secara bermakna pada pasien stroke iskemik dengan diabetes mellitus tipe 2. Kata Kunci     :simvastatin,stroke iskemik, ketebalan intima-media karotis, diabetes mellitus tipe 2      

scholarly journals Relation of Epicardial Fat Thickness with Carotid Intima-Media Thickness in Patients with Type 2 Diabetes Mellitus

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Mustafa Cetin ◽  
Musa Cakici ◽  
Mustafa Polat ◽  
Arif Suner ◽  
Cemil Zencir ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Waist Circumference ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Epicardial Fat Thickness ◽  
Media Thickness ◽  
Fat Thickness

Aims.The aim of this study was to investigate the relationship of echocardiographic epicardial fat thickness (EFT) with carotid intima-media thickness (CIMT), in patients with type 2 diabetes mellitus (T2DM).Methods and Results.A total of 139 patients with T2DM (mean age 54.3 ± 9.2 and 49.6% male) and 40 age and sex-matched control subjects were evaluated. Echocardiographic EFT and ultrasonographic CIMT were measured in all subjects. Patients with T2DM had significantly increased EFT and CIMT than those of the controls (6.0 ± 1.5 mm versus 4.42 ± 1.0 mm,P<0.001and 0.76 ± 0.17 mm versus 0.57 ± 0.14 mm,P<0.001, resp.). EFT was correlated with CIMT, waist circumference, BMI, age, duration of T2DM, HbA1c in the type 2 diabetic patients. Linear regression analysis showed that CIMT (β=3.52,t=3.72,P<0.001) and waist circumference (β=0.36,t=2.26,P=0.03) were found to be independent predictors of EFT. A cutoff high risk EFT value of 6.3 mm showed a sensitivity and specificity of 72.5% and 71.7%, respectively, for the prediction of subclinical atherosclerosis.Conclusion.We found that echocardiographic EFT was significantly higher in patients with T2DM. Our study also showed that EFT was strongly correlated with waist circumference and CIMT as being independent of sex.

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