The synergistic effects of saxagliptin and metformin on CD34+ endothelial progenitor cells in early type 2 diabetes patients: a randomized clinical trial

• DOI: 10.1186/s12933-018-0709-9
• Publication Date: 2018-05-03T11:53:44Z
• Authors: Fiona J. Dore; Cleyton C. Domingues; Neeki Ahmadi; Nabanita Kundu; Yana Kropotova; Sara Houston; Carol Rouphael; Aytan Mammadova; Linda Witkin; Anamil Khiyami; Richard L. Amdur; Sabyasachi Sen
• Keywords: Saxagliptin

Type 2 diabetes is associated with endothelial dysfunction leading to cardiovascular disease. CD34+ Progenitor Cells (EPCs) are responsible for repair and neo-angiogenesis can be used as a disease risk biomarker. This study investigated whether the addition of saxagliptin, DPP-IV inhibitor, metformin, may reduce in improving glycemic control patients.In 12 week, double-blind, randomized placebo-controlled trial, 42 subjects already taking metformin 1-2 grams/day were placebo or saxagliptin 5 mg. Subjects aged 40-70 years < 10 years, no known disease, BMI 25-39.9, HbA1C 6-9% included. We evaluated EPCs number, function, surface markers gene expression, arterial stiffness, blood biochemistries, resting energy expenditure, body composition parameters. A mixed model regression examine vs placebo, accounting within-subject autocorrelation, was done SAS (p 0.05).Although there significant increase cell CD31+ cells percentage increased. Saxagliptin increased migration (in response SDF1α) trend higher colony formation count. MNCs cytometry showed CXCR4 double positivity both CD34 CD31 positive cells, indicating functional improvement. Gene expression analysis an upregulation antioxidant SOD1 0.05) downregulation CD34- IL-6 0.01). For augmentation index systolic pressure measures went down 0.05).Saxagliptin, combination help improve early before macrovascular complications appear. Trial registration registered under clinicaltrials.gov, NCT02024477.