Gueler Ibrahim, Mueller Susanne, Helmschrott Matthias, Oeing Christian U, Erbel Christian, Frankenstein Lutz, Gleißner Christian, Ruhparwar Arjang, Ehlermann Philipp, Dengler Thomas J, Katus Hugo A, Doesch Andreas O
Department of Cardiology, University of Heidelberg, Heidelberg, Germany.
Drug Des Devel Ther. 2013 Apr 8;7:297-303. doi: 10.2147/DDDT.S43092. Print 2013.
Type 2 Diabetes mellitus (T2DM) is a common comorbidity in patients after heart transplantation (HTx) and is associated with adverse long-term outcomes.
The retrospective study reported here analyzed the effects of vildagliptin therapy in stable patients post-HTx with T2DM and compared these with control patients for matched-pairs analysis. A total of 30 stable patients post-HTx with T2DM were included in the study. Fifteen patients (mean age 58.6 ± 6.0 years, mean time post-HTx 4.9 ± 5.3 years, twelve male and three female) were included in the vildagliptin group (VG) and 15 patients were included in the control group (CG) (mean age 61.2 ± 8.3 years, mean time post-HTx 7.2 ± 6.6 years, all male).
Mean glycated hemoglobin (HbA1c) in the VG was 7.4% ± 0.7% before versus 6.8% ± 0.8% after 8 months of vildagliptin therapy (P = 0.002 vs baseline). In the CG, HbA1c was 7.0% ± 0.7% versus 7.3% ± 1.2% at follow-up (P = 0.21). Additionally, there was a significant reduction in mean blood glucose in the VG, from 165.0 ± 18.8 mg/dL to 147.9 ± 22.7 mg/dL (P = 0.002 vs baseline), whereas mean blood glucose increased slightly in the CG from 154.7 ± 19.7 mg/dL to 162.6 ± 35.0 mg/dL (P = 0.21). No statistically significant changes in body weight (from 83.3 ± 10.8 kg to 82.0 ± 10.9 kg, P = 0.20), total cholesterol (1.5%, P = 0.68), or triglyceride levels (8.0%, P = 0.65) were seen in the VG. No significant changes in immunosuppressive drug levels or dosages were observed in either group.
Vildagliptin therapy significantly reduced HbA1c and mean blood glucose levels in post-HTx patients in this study with T2DM and did not have any negative effects on lipid profile or body weight. Thus, vildagliptin therapy presented an interesting therapeutic approach for this selected patient cohort.
2型糖尿病（T2DM）是心脏移植（HTx）术后患者常见的合并症，与不良的长期预后相关。
本回顾性研究分析了维格列汀治疗对HTx术后稳定的T2DM患者的影响，并与对照组患者进行配对分析。该研究共纳入30例HTx术后稳定的T2DM患者。维格列汀组（VG）纳入15例患者（平均年龄58.6±6.0岁，HTx术后平均时间4.9±5.3年，男性12例，女性3例），对照组（CG）纳入15例患者（平均年龄61.2±8.3岁，HTx术后平均时间7.2±6.6年，均为男性）。
VG组糖化血红蛋白（HbA1c）均值在维格列汀治疗前为7.4%±0.7%，治疗8个月后为6.8%±0.8%（与基线相比，P = 0.002）。CG组随访时HbA1c为7.0%±0.7%，与7.3%±1.2%相比（P = 0.21）。此外，VG组平均血糖显著降低，从165.0±18.8mg/dL降至147.9±22.7mg/dL（与基线相比，P = 0.002），而CG组平均血糖略有升高，从154.7±19.7mg/dL升至162.6±35.0mg/dL（P = 0.21）。VG组体重（从83.3±10.8kg降至82.0±10.9kg，P = 0.20）、总胆固醇（1.5%，P = 0.68）或甘油三酯水平（8.0%，P = 0.65）无统计学显著变化。两组免疫抑制药物水平或剂量均未观察到显著变化。
在本研究中，维格列汀治疗显著降低了HTx术后T2DM患者的HbA1c和平均血糖水平，且对血脂或体重无任何负面影响。因此，维格列汀治疗为这一特定患者群体提供了一种有前景的治疗方法。
