Published: 2021-04-28

Effect of sitagliptine and vildagliptine on carotid intima/media thickness in patients with type 2 diabetes mellitus

Ganeswar Sethy, Geetanjali Sethy, Ranjit Rout, Abinash Panda, Adya Anwesha, Prasanta Purohit


Background: Atherosclerosis is a known macro-vascular complication of diabetes mellitus. Gliptins, as a drug class have non-glycemic beneficial action on blood vessels and in addition to their anti-diabetic effects. This study was carried out to find out the effects of sitagliptin and vildagliptin on common carotid intima-media thickness in patients with type 2 diabetes mellitus.

Methods: The observational longitudinal study was carried out on 100 patients with 80 patients with confirmed clinical diagnosis of type 2 diabetes mellitus. They were divided in 3 groups. Group A and Group B received drugs, either sitagliptine or vildagliptin and Group C control group did not receive any drug. High resolution B-mode ultrasonography was carried out for the measurement of intima-media thickness (IMT) of both the common carotid arteries (CCA). Data analysis was done using Microsoft excel spreadsheet and GraphPad Prism version 7.0 (free trial version) software package. A p value of ≤ 0.05 was considered as statistically significant.

Results: The baseline value for the control group was 0.812±0.0748 mm for both the right and left CCA. At 52 weeks the CCA IMT for the right and left CCA were 1.0185± 0.272 mm and 0.936±0.149 mm respectively. At 104 weeks the CCA IMT for the right and left CCA were 0.923±0.243 mm and 0.859±0.123 mm respectively.

Conclusions: There was a significant decrease in carotid intima-media thickness in patients of type-2 diabetes mellitus treated with sitagliptin and vildagliptin.


Common carotid artery intima/media thickness, Dipeptidyl peptidase-4 inhibitors, Type -2 diabetes mellitus

Full Text:



Scheen AJ. Cardiovascular effects of dipeptidyl peptidase-4 inhibitors: from risk factors to clinical outcomes. Postgrad Med. 2013;125(3):7-20.

Kokubo Y, Watanabe M, Higashiyama A, Nakao YM, Nakamura F, Miyamoto WY, et al. Impact of intima-media thickness progression in the common carotid arteries on the risk of incident cardiovascular disease in the suita study. J Am Heart Assoc. 2018;7(11):e007720.

Ravani A, Werba JP, Frigerio B, Sansaro D, Amato M, Tremoli E, et al. Assessment and relevance of carotid intima-media thickness (C-IMT) in primary and secondary cardiovascular prevention. Curr Pharm Des. 2015;21(9):1164-71.

Lorenz MW, Price JF, Robertson C, Bots ML, Polak JF, Poppert H, et al. Carotid intima-media thickness progression and risk of vascular events in people with diabetes: results from the PROG-IMT collaboration. Diabetes Care. 2015;38(10):1921-9.

Blum A, Nahir M. Future non-invasive imaging to detect vascular plaque instability and subclinical non-obstructive atherosclerosis. J Geriatr Cardiol. 2013;10(2):178-85.

Mahmoud MZ. Sonography of common carotid arteries' intima: media thickness in the normal adult population in Sudan. N Am J Med Sci. 2013;5(2):88-94.

Santamarina M, Carlson CJ. Review of the cardiovascular safety of dipeptidyl peptidase-4 inhibitors and the clinical relevance of the CAROLINA trial. BMC Cardiovasc Disord. 2019;19(1):60.

Liviakis L, Pogue B, Paramsothy P, Bourne A, Gill E. Carotid intima-media thickness for the practicing lipidologist. J Clin Lipidol. 2010;4:24-35.

Stein JH, Korcarz CE, Hurst RT, Lonn E, Kendall CB, Mohler ER, et al. Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid intima-media thickness task force. endorsed by the society for vascular medicine. J Am Soc Echocardiogr. 2008;21:93-111.

Polak JF, Pencina MJ, Meisner A. Associations of carotid artery intima-media thickness (IMT) with risk factors and prevalent cardiovascular disease: comparison of mean common carotid artery IMT with maximum internal carotid artery IMT. J Ultrasound Med. 2010;29(12):1759-1768.

Paul J, Dasgupta S, Ghosh MK. Carotid artery intima media thickness as a surrogate marker of atherosclerosis in patient with chronic renal failure on hemodialysis. N Am J Med Sci. 2012;4:77-80.

Mahmoud MZ. Sonography of common carotid arteries' intima: media thickness in the normal adult population in Sudan. N Am J Med Sci. 2013;5(2):88-94.

Youn YJ, Lee NS, Kim JY, Lee JW, Sung JK, Ahn SG, et al. Normative values and correlates of mean common carotid intima-media thickness in the Korean rural middle-aged population: the atherosclerosis risk of rural areas in korea general population (ARIRANG) study. J Korean Med Sci. 2011;26:365-71.

Jacoby DS, Mohler IE, Rader DJ. Noninvasive atherosclerosis imaging for predicting cardiovascular events and assessing therapeutic interventions. Curr Atheroscler Rep. 2004;6:20-6.

Hansa G, Bhargava K, Bansal M, Tandon S, Kasliwal RR. Carotid intima-media thickness and coronary artery disease: An Indian perspective. Asian Cardiovasc Thorac Ann. 2003;11:217-21.

O'Leary DH, Bots ML. Imaging of atherosclerosis: Carotid intima-media thickness. Eur Heart J. 2010;31:1682-9.

Ballantyne CM. Clinical Lipidology: A companion to Braunwald's heart diseases. 1 st ed. Saunders Elsevier Publication; 2008:608.

Crouse JR, Tang R, Espeland MA, Terry JG, Morgan T, Mercuri M. Associations of extra-cranial carotid atherosclerosis progression with coronary status and risk factors in patients with and without coronary artery disease. Circulation. 2002;106:2061-6.

Lee EJ, Kim HJ, Bae JM, Kim JC, Han HJ, Park CE, et al. Relevance of common carotid intima-media thickness and carotid plaque as risk factors for ischemic stroke in patients with type 2 diabetes mellitus American J Neuroradiol. 2007;28(5):916-9.

Cupini LM, Pasqualetti P, Diomedi M. Carotid artery intima-media thickness and lacunar versus nonlacunar infarcts. Stroke. 2002;33:689-94.

Matsumoto K, Sera Y, Nakamura H. Correlation between common carotid arterial wall thickness and ischemic stroke in patients with type 2 diabetes mellitus. Metabolism. 2002;51:244-7.

Kawamori R, Yamasaki Y, Matsushima H. Prevalence of carotid atherosclerosis in diabetic patients. Diabetes Care. 1992;15:1290-4.

Langenfeld MR, Forst T, Hohberg C. Pioglitazone decreases carotid intima-media thickness independently of glycemic control in patients with type 2 diabetes mellitus: results from a controlled randomized study. Circulation. 2005;111(19):2525-31.

Yamasaki Y, Katakami N, Furukado S. Long-term effects of pioglitazone on carotid atherosclerosis in Japanese patients with type 2 diabetes without a recent history of macrovascular morbidity. J Atherosclerosis Thrombosis. 2010;17(11):1132-40.

Katakami N, Mita T, Irie Y. Effect of sitagliptin on tissue characteristics of the carotid wall in patients with type 2 diabetes: a post hoc sub-analysis of the sitagliptin preventive study of intima-media thickness evaluation (SPIKE). Cardiovasc Diabetol. 2018;17:24.

Lu Z, Ma G, Chen L. Sitagliptin on carotid intima-media thickness in type 2 diabetes mellitus patients and anemia: a subgroup analysis of the prologue study. Mediators Inflamm. 2020;2020:8143835.

Barbieri M, Rizzo MR, Marfella R, Boccardi V, Esposito A, Pansini A, et al. Decreased carotid atherosclerotic process by control of daily acute glucose fluctuations in diabetic patients treated by DPP-IV inhibitors. Ahterosclerosis. 2013;227(2):349-54.