Background: Recently, The dipeptidyl peptidase-4 (DPP-4) inhibitor, sitagliptin contributes to improvement of postprandial hyperglycemia and prevents risk of hypoglycemia through increasing the level of glucagon-like polypeptide (GLP-1) as new therapeutic target and novel pathway for correcting impaired glucose homeostasis in type 2 diabetes mellitus (T2DM). Aim: This study was conducted to assess the cardioprotective effect of sitagliptin on cardiovascular complications in Egyptian male patients with T2DM. Methods: The study enrolled 12 apparently healthy control subjects, 20 diabetic patients having no cardiovascular complications on 1 gm metformin orally daily for 3 months and 25 diabetic patients having cardiovascular complications on 1 gm metformin orally daily for 3 months then adding 100 mg Sitagliptin orally daily for 3 months. All subjects involved in this study are males having index of central obesity(ICO) < 0.55 The following parameters involved in this study are fasting plasma glucose (FPG), Glycated hemoglobin (HbA1C), insulin, proinsulin, proinsulin/insulin (PI/IN) ratio, hemostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), very low density lipoprotein (VLDL), oxidized low density lipoprotein (Ox-LDL), risk ratio 1&2 (RR1)(RR2), creatine kinase MB (CK-MB), lactate dehydrogenase (LDH), plasminogen activator inhibitor-1 (PAI-1), cardiac troponin-I (cTnI), and homocysteine Results: Sitagliptin significantly reduced FPG, HbA1C, insulin, proinsulin, proinsulin/insulin ratio, HOMA-IR index, TC, TG, LDL, VLDL, OX-LDL, RR 1, RR 2, CK-MB, LDH, PAI-1, cTnI AND homocysteine compared to non Sitagliptin group, whereas HDL was significantly increased in sitagliptin group compared to non Sitagliptin group. Conclusion: Sitagliptin is effective not only on glycaemic control and insulin sensitivity but, also it ameliorates dyslipidemia, endothelial dysfunction and cardiovascular complications and in T2DM.
