Tomoya Mita and Naoto Katakami drafted the manuscript. Hospital, Naka Memorial Clinic, Osaka General Medical Center, Osaka Police Hospital, Osaka University Graduate School of Fmoc-Lys(Me)2-OH HCl Medicine, and Sasebo Chuo Hospital) in compliance with the Declaration of Helsinki and current legal regulations in Japan. Consent Written informed consent was obtained from all the participants after full explanation of the study. Disclosure The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests Tomoya Mita received research funds from MSD and Takeda Pharma K.K. and has received lecture fees from AstraZeneca K.K., Boehringer Ingelheim, Eli Lilly, Kowa Pharmaceutical Co., Mitsubishi Tanabe Pharma Co., MSD, Ono Pharmaceutical Co., and Takeda Pharmaceutical Co. Naoto Katakami is usually a staff member of the endowed chair (Department of Metabolism and Atherosclerosis) established by funds from Kowa Pharmaceutical Co. and has received research funds from MSD and lecture fees from Astellas Pharma Inc., AstraZeneca K.K., Boehringer Ingelheim, Daiichi Sankyo Inc., Dainippon Sumitomo Pharma Co., Eisai Co., Eli Fmoc-Lys(Me)2-OH HCl Lilly, Kowa Pharmaceutical Co., Mitsubishi Tanabe Pharma Co., Novartis Pharmaceuticals, Novo Nordisk Pharma, Ono Pharmaceutical Co., Otsuka Pharmaceutical, Shionogi & Co., Takeda Pharmaceutical Co., Sanofi-Aventis, and Shionogi & Co. Toshihiko Shiraiwa has received lecture fees from Boehringer Ingelheim, Sanofi-Aventis, Novo Nordisk Pharma, Novartis Pharmaceuticals, Eli Lilly, Abbott Japan, Takeda Pharmaceutical Co., Sanwa Kagaku Kenkyusho Co. Ltd., Mitsubishi Tanabe Pharma Co., Daiichi Sankyo Inc., Astellas Pharma Inc., Ono Pharmaceutical Co., MSD, Shionogi, Pharma, and Taisho Toyama Pharmaceutical Co. Masahiko Gosho received lecture fees from Novartis and Tiho Pharma K.K., received travel fees from Takeda Pharmaceutical Co., and received manuscript fee from Kowa Co., Ltd. Iichiro Shimomura has received lecture fees from Astellas Pharma Inc., AstraZeneca K.K., MSD K.K., Ono Pharmaceutical Co., Kyowa Hakko Kirin Co., Ltd., Kowa Pharmaceutical Co., Sanofi K.K., Sanwa Kagaku Kenkyusho Co., Ltd., Daiichi Sankyo Co., Takeda Pharma K.K., Mitsubishi Tanabe Pharma Co., Teijin Pharma, Eli Lilly Japan K.K., Nippon Boehringer Ingelheim Co., Novartis Pharma K.K., Rabbit Polyclonal to C-RAF (phospho-Ser301) Novo Nordisk Pharma, Bayer Yakuhin, Pfizer Japan Inc., Bristol-Myers K.K., Mochida Pharmaceutical Co., Shionogi & Co., Taisho Toyama Pharmaceutical Co., and Shionogi & Co. and research funds from Astellas Pharma Inc., AstraZeneca K.K., Eisai Co., MSD K.K., Otsuka Pharmaceutical Co., Ono Pharmaceutical Co., Kaken Pharmaceutical Co., Kissei Pharmaceutical Co., Kyowa Hakko Kirin Co., Ltd., Sanofi K.K., Shionogi & Co., Daiichi Sankyo Co., Dainippon Sumitomo Pharma Co., Takeda Pharma K.K., Mitsubishi Tanabe Pharma Co., Teijin Pharma, Nippon Boehringer Ingelheim Co., Novartis Pharma K.K., Novo Nordisk Pharma, Pfizer Japan Inc., Bristol-Myers K.K., Mochida Pharmaceutical Co., Eli Lilly Japan K.K., Kowa Co., Ltd., Kowa Pharmaceutical Co., and Taisho Toyama Pharmaceutical Co. Hirotaka Watada has received lecture fees from Novo Nordisk, Inc., Eli Lilly and Company, Sanofi, Dainippon Sumitomo Pharma Co., Fujifilm, Bayer Health Care, Kissei Pharmaceutical Company, Mochida Pharmaceutical Company, MSD, Takeda Pharmaceutical Company, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi-Sankyo, Ono Pharmaceutical Co., Ltd., Novartis Pharmaceuticals Corporation, Mitsubishi Tanabe Pharma Corporation, AstraZeneca LP, Kyowa Hakko Kirin Co., Ltd., Sanwa Kagaku Kenkyusho Co., Ltd., Kowa Company Ltd., and Astellas Pharma, Inc., advisory fees from Novo Nordisk, Inc., Mochida Pharma Company, AstraZeneca LP, Kowa Company, Astellas Pharma, Inc., Sanofi, Boehringer Ingelheim Pharmaceuticals, Inc., MSD, Mitsubishi Tanabe Pharma Corporation, Novartis Pharmaceuticals Corporation, Dainippon Sumitomo Pharma Co., Takeda Pharmaceutical Company, Ono Pharmaceutical Co., Pfizer, Inc., and Kowa Company, and research funds from Boehringer Ingelheim, Pfizer, Mochida Pharmaceutical Co., Sanofi-Aventis, Novo Nordisk Pharma, Novartis Pharmaceuticals, Sanwa Kagaku Kenkyusho Co., Ltd., Terumo Corp., Eli Lilly, Mitsubishi Tanabe Pharma, Daiichi Sankyo Inc., Takeda Pharmaceutical Co., MSD, Shionogi, Pharma, Dainippon Sumitomo Pharma, Kissei Pharma, and AstraZeneca. Authors’ Contributions The authors meet the criteria for authorship recommended by the International Committee of Medical Journal Editors and take full responsibility for all those contents of the.Financial support for this study was provided by the Japan Society for Patients Reported Outcome research fund from Mitsubishi Tanabe, Ono, and Novo Nordisk. Abbreviations CI:Confidence intervalCVD:Cardiovascular diseaseDPP-4:Dipeptidyl peptidase-4IMT:Intima-media thicknessMax-IMT-CCA:Maximum IMT of the common carotid arteryMean-IMT-CCA:Mean IMT of the common carotid arteryOHA:Oral hypoglycemic agentsOR:Odds ratioSPIKE:Sitagliptin Preventive Study of Intima-Media Thickness EvaluationT2DM:Type 2 diabetes mellitus. Ethical Approval This protocol was approved by the Institutional Review Board Fmoc-Lys(Me)2-OH HCl of each participating institution (Jiyugaoka Medical Clinic, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University Graduate School of Medicine, Kansai Rosai Hospital, Naka Memorial Clinic, Osaka General Medical Center, Osaka Police Hospital, Osaka University Graduate School of Medicine, and Sasebo Chuo Hospital) in compliance with the Declaration of Helsinki and current legal regulations in Japan. Consent Written informed consent was obtained from all the participants after full explanation of the study. Disclosure The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests Tomoya Mita received research funds from MSD and Takeda Pharma K.K. Thickness EvaluationT2DM:Type 2 diabetes mellitus. Ethical Approval This protocol was approved by the Institutional Review Board of each participating institution (Jiyugaoka Medical Clinic, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University Graduate School of Medicine, Kansai Rosai Hospital, Naka Memorial Clinic, Osaka General Medical Center, Osaka Police Hospital, Osaka University Graduate School of Medicine, and Sasebo Chuo Hospital) in compliance with the Declaration of Helsinki and current legal regulations in Japan. Consent Written informed consent was obtained from all the participants after full explanation of the study. Disclosure The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests Tomoya Mita received research funds from MSD and Takeda Pharma K.K. and has received lecture fees from AstraZeneca K.K., Boehringer Ingelheim, Eli Lilly, Kowa Pharmaceutical Co., Mitsubishi Tanabe Pharma Co., MSD, Ono Pharmaceutical Co., and Takeda Pharmaceutical Co. Naoto Katakami is usually a staff member of the endowed chair (Department of Metabolism and Atherosclerosis) established by funds from Kowa Pharmaceutical Co. and has received research funds from MSD and lecture fees from Astellas Pharma Inc., AstraZeneca K.K., Boehringer Ingelheim, Daiichi Sankyo Inc., Dainippon Sumitomo Pharma Co., Eisai Co., Eli Lilly, Kowa Pharmaceutical Co., Mitsubishi Tanabe Pharma Co., Novartis Pharmaceuticals, Novo Nordisk Pharma, Ono Pharmaceutical Co., Otsuka Pharmaceutical, Shionogi & Co., Takeda Pharmaceutical Co., Sanofi-Aventis, and Shionogi & Co. Toshihiko Shiraiwa has received lecture fees from Boehringer Ingelheim, Sanofi-Aventis, Novo Nordisk Pharma, Novartis Pharmaceuticals, Eli Lilly, Abbott Japan, Takeda Pharmaceutical Co., Sanwa Kagaku Kenkyusho Co. Ltd., Mitsubishi Tanabe Pharma Co., Daiichi Sankyo Inc., Astellas Pharma Inc., Ono Pharmaceutical Co., MSD, Shionogi, Pharma, and Taisho Toyama Pharmaceutical Co. Masahiko Gosho received lecture fees from Novartis and Tiho Pharma K.K., received travel fees from Takeda Pharmaceutical Co., and received manuscript fee from Kowa Co., Ltd. Iichiro Shimomura has received lecture fees from Astellas Pharma Inc., AstraZeneca K.K., MSD K.K., Ono Pharmaceutical Co., Kyowa Hakko Kirin Co., Ltd., Kowa Pharmaceutical Co., Sanofi K.K., Sanwa Kagaku Kenkyusho Co., Ltd., Daiichi Sankyo Co., Takeda Pharma K.K., Mitsubishi Tanabe Pharma Co., Teijin Pharma, Eli Lilly Japan K.K., Nippon Boehringer Ingelheim Co., Novartis Pharma K.K., Novo Nordisk Pharma, Bayer Yakuhin, Pfizer Japan Inc., Bristol-Myers K.K., Mochida Pharmaceutical Co., Shionogi & Co., Taisho Toyama Pharmaceutical Co., and Shionogi & Co. and research funds from Astellas Pharma Inc., AstraZeneca K.K., Eisai Co., MSD K.K., Otsuka Pharmaceutical Co., Ono Pharmaceutical Co., Kaken Pharmaceutical Co., Kissei Pharmaceutical Co., Kyowa Hakko Kirin Co., Ltd., Sanofi K.K., Shionogi & Co., Daiichi Sankyo Co., Dainippon Sumitomo Pharma Co., Takeda Pharma K.K., Mitsubishi Tanabe Pharma Co., Teijin Pharma, Nippon Boehringer Ingelheim Co., Novartis Pharma K.K., Novo Nordisk Pharma, Pfizer Japan Inc., Bristol-Myers K.K., Mochida Pharmaceutical Co., Eli Lilly Japan K.K., Kowa Co., Ltd., Kowa Pharmaceutical Co., and Taisho Toyama Pharmaceutical Co. Hirotaka Watada has received lecture fees from Novo Nordisk, Inc., Eli Lilly and Company, Sanofi, Dainippon Sumitomo Pharma Co., Fujifilm, Bayer Health Care, Kissei Pharmaceutical Company, Mochida Pharmaceutical Company, MSD, Takeda Pharmaceutical Company, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi-Sankyo, Ono Pharmaceutical Co., Ltd., Novartis Pharmaceuticals Corporation, Mitsubishi Tanabe Pharma Corporation, AstraZeneca LP, Kyowa Hakko Kirin Co., Ltd., Sanwa Kagaku Kenkyusho Co., Ltd., Kowa Business Ltd., and Astellas Pharma, Inc., advisory charges from Novo Nordisk, Inc., Mochida Pharma Business, AstraZeneca LP, Kowa Business, Astellas Pharma, Inc., Sanofi, Boehringer Ingelheim Pharmaceuticals, Inc.,.