Effect of sitagliptin on epicardial fat thickness in subjects with type 2 diabetes and obesity: A pilot study
Abstract
The aim of the study was to assess the effect of sitagliptin addition on the epicardial adipose tissue (EAT) thickness in subjects with type 2 diabetes mellitus inadequately controlled on metformin monotherapy. This was a 24-week interventional pilot study in 26 consecutive type 2 diabetic patients, 14 females and 12 males average age of 43.8 ± 9.0 years, with Hemoglobin A1c (HbA1c) ≥ 7% on metformin monotherapy. Subjects who met the inclusion criteria were added on sitagliptin and started on sitagliptin/metformin combination at the dosage of 50 mg/1000 mg twice daily. EAT and visceral and total body fat were measured, respectively, with echocardiography and bioelectrical impedance analysis at baseline and after 24 weeks of sitagliptin/metformin treatment in each subject. HbA1c and plasma lipids were also measured. EAT decreased significantly from 9.98 ± 2.63 to 8.10 ± 2.11 mm, p = 0.001, accounting for a percentage of reduction (∆%) of -15% after 24 weeks of sitagliptin addition, whereas total body fat percentage, visceral fat, and body mass index (BMI), decreased by 8, 12, and 7%, respectively (p = 0.001 for all). After 6 month, EAT ∆% was significantly correlated with ∆% of visceral fat (r = 0.456; p = 0.01), whereas no correlation with either BMI ∆% (r = 0.292; p = 0.147) or HbA1c ∆% was found. The addition of Sitagliptin produced a significant and rapid reduction of EAT, marker of organ-specific visceral fat, in overweight/obese individuals with type 2 diabetes inadequately controlled on metformin monotherapy. EAT as measured with ultrasound can serve as no invasive and accurate marker of visceral fat changes during pharmaceutical interventions targeting the fat.
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Sitagliptin or liraglutide as add-on therapy in overweight/obese T2DM inadequately controlled on metformin significantly reduce EAT after six months, whereas no such result is detected in metformin groups.
“Recently, two randomized trials evaluating EAT changes induced after six months by sitagliptin or liraglutide as add-on therapy in overweight/obese T2DM individuals inadequately controlled on metformin monotherapy showed that both incretin-based therapies significantly reduced EAT, whereas no such result was detected in the metformin groups [122,123].”
From Dysregulated epicardial adipose tissue as a risk factor and potential therapeutic target of heart failure with preserved ejection fraction in diabetes (2022) · cites this paper as [122]
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“In this line, sitagliptin, a DPP-4 inhibitor that avoid GLP-1 degradation, reduced also EAT (15%) in parallel to VAT and more intensively than BMI and waist circumference, in T2DM individuals [114].”
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- Authors
- Lima-Martínez, M. M., Paoli, M., Rodney, M., Balladares, N., Contreras, M., D’Marco, L., & Iacobellis, G.
- Affiliations
- Universidad de Oriente (VE)
- Universidad de Los Andes (VE)
- University of Miami (US)
- Corresponding author
- Lima-Martínez, Marcos M.
- Venue
- Endocrine
- Published
- 2015-08-02
- Volume
- 51
- Issue
- 3
- Pages
- 448-455
- ISSN
- 0969-711X (ISSN-L)
- 1355-008X
- 1559-0100
- OpenAlex
- W948379226
- Cited by
- 92
- References
- 49
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 3 · 2023: 11 · 2022: 12 · 2021: 11 · 2020: 12 · 2019: 11 · 2018: 11 · 2017: 8 · 2016: 3
- FWCI
- 5.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Endocrine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- sitagliptin, epicardial adipose tissue, epicardial fat thickness, type 2 diabetes, obesity, metformin monotherapy, DPP-4 inhibitors, combination therapy, visceral fat, body mass index, glycemic control, HbA1c, echocardiography, bioelectrical impedance analysis
- MeSH terms
- Sitagliptin Phosphate, Adipose Tissue, Adolescent, Adult, Aged, Body Composition, Diabetes Mellitus, Type 2, Drug Therapy, Combination, Female, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Lipids, Male, Metformin, Middle Aged, Obesity, Pericardium, Pilot Projects, Electric Impedance, Adiposity, Young Adult
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