Alogliptin ameliorates postprandial lipemia and postprandial endothelial dysfunction in non- diabetic subjects: a preliminary report

A randomized cross-over trial design in 10 healthy volunteers (8 males and 2 females, 35 ± 10 years) was performed. The postprandial effects before and after a 1-week treatment of 25 mg/day alogliptin on endothelial function were assessed with brachial artery flow-mediated dilation (FMD) and changing levels of lipids, apolipoprotein B48 (apoB-48), glucose, glucagon, insulin, and glucagon-like peptide-1 (GLP-1) during fasting and at 2, 4, 6, and 8 h after a standard meal loading test.Alogliptin treatment significantly suppressed the postprandial elevation in serum triglyceride (incremental area under the curve [AUC]; 279 ± 31 vs. 182 ± 32 mg h/dl, p = 0.01), apoB-48 (incremental AUC; 15.4 ± 1.7 vs. 11.7 ± 1.1 μg h/ml, p = 0.04), and remnant lipoprotein cholesterol (RLP-C) (incremental AUC: 29.3 ± 3.2 vs. 17.6 ± 3.3 mg h/dl, p = 0.01). GLP-1 secretion was significantly increased after alogliptin treatment. Postprandial endothelial dysfunction (maximum decrease in%FMD, from ？4.2 ± 0.5% to ？2.6 ± 0.4%, p = 0.03) was significantly associated with the maximum change in apoB-48 (r = ？0.46, p = 0.03) and RLP-C (r = ？0.45, p = 0.04).Alogliptin significantly improved postprandial endothelial dysfunction and postprandial lipemia, suggesting that alogliptin may be a promising anti-atherogenic agent.Large prospective studies have shown that non-fasting postprandial triglyceride (TG) concentrations predict cardiovascular risk better than fasting TG concentrations and that this relationship is independent of traditional coronary risk factors [1,2]. TG-rich lipoproteins, which consist of chylomicrons assembled by TG, dietary cholesterol, and apolipoprotein B-48 (apoB-48), are highly atherogenic and contribute to the development of coronary heart disease. Thus, the increased risk of cardiovascular events associated with non-fasting TG concentrations may reflect atherogenic properties of TG-rich lipoproteins generated during the postprandial period [3]. Studies have shown that postpr