Dipeptidyl peptidase 4 (DPP-4) inhibitors are approved as add on therapy to improve glycaemic
control in Type 2 Diabetes Mellitus (T2DM). DPP-4 inactivates the incretin hormone
glucagon-like peptide 1 (GLP-1). Inhibiting the inactivation of GLP-1 leads to increased
insulin- and reduced glucagon secretion after meals. DPP-4 has been shown to be present in
atherosclerotic plaques. DPP-4 is a protease with substrates including cytokines and
chemokines associated with atherosclerosis/inflammation.
The purpose of this study is to explore the effects of 3 months intervention with DPP-4
inhibitor saxagliptin on biomarkers related to atherosclerosis in patients with stable
coronary artery disease (CAD) and T2DM, on circulating levels and on expression levels in
circulating monocytes and adipose tissue.
A reduction in markers associated with atherosclerosis could indicate an antiatherosclerotic
effect of DPP-4 inhibitors beyond glycaemic control alone.
Due to reduced sample size (recruitment problems) the main focus has changed and will now be
on cellular aspects and gene regulation (initially secondary outcome measure).