Objectives: Type 2 diabetes mellitus(T2DM) can accelerate the clinical
process of atherosclerosis(AS). Dipeptidyl peptidase-4
inhibitors(DPP-4Is) have potential anti-AS effects. And, we completed a
meta-analysis of the changes in carotid intima-media thickness(CIMT),
flow-mediated dilation(FMD), and pulse wave velocity(PWV) of DPP-4Is to
research the effect of DPP-4Is in the progression of AS in T2DM
patients. Materials and methods: We included RCTs that evaluated the
impact of DPP-4Is on CIMT, FMD, and PWV compared to other treatments
from PubMed, Cochrane trials, and Embase database before October 31,
2020. We selected the random-effect model and calculated the weighted
mean difference(WMD) to evaluate the effect of CIMT, FMD, and PWV in
T2DM patients. Results：Through the meta-analysis, we found that DPP-4Is
can significantly reduce CIMT in T2DM patients(WMD =-0.036, 95%
CI:-0.055 to-0.017; p≤0.001). Based on the subgroup analysis, we found
that CIMT was significantly decreased in patients with greater than 12
months of intervention and without cardiovascular diseases. Besides, we
also found that DPP-4Is had a not significant efficacy on the
improvement of FMD in T2DM patients(WMD=0.635, 95% CI: -0.112 to 1.383,
p= 0.097). Our subgroup analysis showed that for T2DM patients who have
cardiovascular diseases, DPP-4Is can significantly increase their FMD.
In addition, we also found that DPP-4Is had an insignificant influence
on PWV in T2DM patients(WMD= 0.424, 95% CI: -0.198 to 1.046, p= 0.18).
but SGLT2 inhibitors may reduce the PWV of T2DM patients. Conclusions:
DPP-4Is can alleviate the development of AS in T2DM patients to a
certain extent by reducing CIMT. And, we believe that long-term use of
DPP-4Is may be more helpful to alleviate the atherosclerotic development
of T2DM without obvious cardiovascular history.
Risks of cardiovascular diseases associated with dipeptidyl peptidase-4 inhibitors and other antidiabetic drugs in patients with type 2 diabetes: a nation-wide longitudinal study