Influence of saxagliptin on left ventricular systolic function in type 2 diabetes patients

doi:10.3877/cma.j.issn.1674-0785.2017.14.004

Abstract

Abstract:

Objective

To evaluate the influence of saxagliptin on left ventricular systolic function in type 2 diabetes mellitus (T2DM) patients.

Methods

A total of 423 patients with T2DM who had been treated with hypoglycemic agents were collected. Subjects were assigned into either a saxagliptin treatment group or a conventional treatment group. Echocardiography was performed in all subjects, and the results were compared between the two groups. According to left ventricular systolic function, the patients were divided into either a normal or an impaired group, and between-group differences were assessed. Logistic regression analysis was used to evaluation the association of saxagliptin with left ventricular systolic function.

Results

Compared to the conventional treatment group, patients in the saxagliptin treatment group had significantly smaller left ventricular end-diastolic diameter [(49.3 ± 6.1) mm vs (52.5 ± 6.6) mm, P<0.05], but significantly greater left ventricular ejection fraction (61.6 ± 3.4)% vs (58.4 ± 5.2)%, P<0.05. Compared to patients with left ventricular systolic function impairment, those with normal left ventricular systolic function had significantly higher percentage of saxagliptin usage (51.9% vs 28.1%, P<0.05), smaller left ventricular end-diastolic diameter, and lower blood pressure and blood glucose. Logistic regression analysis showed that saxagliptin had a protective effect for left ventricular systolic function.

Conclusion

Sitagliptin may have the potential value to improve left ventricular systolic function in T2DM patients.

Key words: Type 2 diabetes, Saxagliptin, Left ventricular systolic function

Yunjie Teng, Yuying Du, Shuxia Wang. Influence of saxagliptin on left ventricular systolic function in type 2 diabetes patients[J]. Chinese Journal of Clinicians(Electronic Edition), 2017, 11(14): 2028-2032.

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References 17

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临床资料	沙格列汀组	非沙格列汀组
例数	206	217
年龄（岁，±s）	49.3±12.7	51.6±14.2
男性（%）	61.2	56.2
BMI（kg/m²，±s）	23.3±2.6	22.9±2.2
收缩压（mmHg，±s）	120.6±11.7	122.5±12.4
舒张压（mmHg，±s）	81.4±8.6	82.7±8.6
空腹血糖（?mmol?/L，±s）	7.2±1.2	6.9±1.6
糖化血红蛋白（%，±s）	6.6±1.5	6.4±1.1
肌酐（?μmol?/L，±s）	110.4±17.7	108.6±13.8
BNP（?ng?/L，±s）	62.0±4.2	65.0±4.6
三酰甘油（?mmol?/L，±s）	1.3±0.5	1.5±0.9^a
抗血小板聚集药物（%）	88.6	86.1
他汀类药物（%）	70.7	71.3
左心室收缩末径（mm，±s）	37.3±7.2	38.2±8.6
左心室舒张末径（mm，±s）	49.3±6.1	52.5±6.6^a
LVEF（%，±s）	61.6±3.4	58.4±5.2^a

临床资料	沙格列汀组	非沙格列汀组
例数	206	217
年龄（岁，±s）	49.3±12.7	51.6±14.2
男性（%）	61.2	56.2
BMI（kg/m²，±s）	23.3±2.6	22.9±2.2
收缩压（mmHg，±s）	120.6±11.7	122.5±12.4
舒张压（mmHg，±s）	81.4±8.6	82.7±8.6
空腹血糖（?mmol?/L，±s）	7.2±1.2	6.9±1.6
糖化血红蛋白（%，±s）	6.6±1.5	6.4±1.1
肌酐（?μmol?/L，±s）	110.4±17.7	108.6±13.8
BNP（?ng?/L，±s）	62.0±4.2	65.0±4.6
三酰甘油（?mmol?/L，±s）	1.3±0.5	1.5±0.9^a
抗血小板聚集药物（%）	88.6	86.1
他汀类药物（%）	70.7	71.3
左心室收缩末径（mm，±s）	37.3±7.2	38.2±8.6
左心室舒张末径（mm，±s）	49.3±6.1	52.5±6.6^a
LVEF（%，±s）	61.6±3.4	58.4±5.2^a

变量	LVEF＜50%	LVEF≥50%
例数	57	366
年龄（岁，±s）	57.6±12.4	52.5±10.8^b
男性（%）	59.7	58.5
吸烟（%）	60.6	40.3^a
BMI（kg/m²，±s）	24.7±5.2	23.5±6.3
收缩压（mmHg，±s）	133.3±6.8	121.7±5.5^b
舒张压（mmHg，±s）	85.6±5.9	72.1±4.3^b
空腹血糖（?mmol?/L，±s）	10.9±2.4	6.4±1.7^b
糖化血红蛋白（%，±s）	8.5±1.2	7.3±1.1^b
肌酐（?μmol?/L，±s）	111.6±15.3	109.4±14.0
BNP（?ng?/L，±s）	267.0±11.0	58.0±2.1^b
三酰甘油（?mmol?/L，±s）	1.7±0.4	1.5±0.5
抗血小板聚集药物（%）	67.3	90.4^b
他汀类药物（%）	50.3	85.6^b
胰岛素（%）	68.1	55.2
沙格列汀（%）	28.1	51.9^b
磺脲类（%）	25.6	27.3
二甲双胍（%）	38.1	37.8
α糖苷酶抑制剂（%）	29.4	34.4
噻唑烷二酮类（%）	5.3	6.8
左心室收缩末径（mm，±s）	39.4±8.1	36.9±7.6^a
左心室舒张末径（mm，±s）	56.8±7.8	50.5±6.4^b
左心室射血分数（%，±s）	45.3±4.2	58.7±7.8^b
高血压（%）	57.6	44.8^a
冠心病（%）	16.1	5.4^b

变量	LVEF＜50%	LVEF≥50%
例数	57	366
年龄（岁，±s）	57.6±12.4	52.5±10.8^b
男性（%）	59.7	58.5
吸烟（%）	60.6	40.3^a
BMI（kg/m²，±s）	24.7±5.2	23.5±6.3
收缩压（mmHg，±s）	133.3±6.8	121.7±5.5^b
舒张压（mmHg，±s）	85.6±5.9	72.1±4.3^b
空腹血糖（?mmol?/L，±s）	10.9±2.4	6.4±1.7^b
糖化血红蛋白（%，±s）	8.5±1.2	7.3±1.1^b
肌酐（?μmol?/L，±s）	111.6±15.3	109.4±14.0
BNP（?ng?/L，±s）	267.0±11.0	58.0±2.1^b
三酰甘油（?mmol?/L，±s）	1.7±0.4	1.5±0.5
抗血小板聚集药物（%）	67.3	90.4^b
他汀类药物（%）	50.3	85.6^b
胰岛素（%）	68.1	55.2
沙格列汀（%）	28.1	51.9^b
磺脲类（%）	25.6	27.3
二甲双胍（%）	38.1	37.8
α糖苷酶抑制剂（%）	29.4	34.4
噻唑烷二酮类（%）	5.3	6.8
左心室收缩末径（mm，±s）	39.4±8.1	36.9±7.6^a
左心室舒张末径（mm，±s）	56.8±7.8	50.5±6.4^b
左心室射血分数（%，±s）	45.3±4.2	58.7±7.8^b
高血压（%）	57.6	44.8^a
冠心病（%）	16.1	5.4^b

自变量	β	SE	Β′	t值	P值
年龄（岁）	2.945	0.221	2.765	3.24	0.041
吸烟史	1.324	0.244	1.208	2.375	0.023
单用沙格列汀	-2.677	0.12	2.603	4.217	＜0.001
空腹血糖（?mmol?/L）	2.001	0.121	2.675	2.155	＜0.001
糖化血红蛋白（%）	2.791	0.125	2.313	3.051	＜0.001
高血压病史	3.154	0.105	2.903	4.205	＜0.001

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