Antiatherogenic effect of pioglitazone in type 2 diabetic patients irrespective of the responsiveness to its antidiabetic effect.
OBJECTIVE
Thiazolidinediones (TZDs), a class of insulin-sensitizing agents used clinically to treat type 2 diabetes, are also antiatherogenic. This study was designed to elucidate the relationship between the antiatherogenic and antidiabetic effects of pioglitazone, a TZD, in type 2 diabetic patients.


METHODS
A total of 136 Japanese type 2 diabetic patients were included and divided into two groups: the pioglitazone-treated group (30 mg daily for 3 months) (n = 70) and the untreated control group (n = 66). The changes in glycolipid metabolism as well as plasma high-sensitivity C-reactive protein (CRP), leptin, adiponectin, and pulse wave velocity (PWV) were monitored to analyze the relationship between the antiatherogenic and antidiabetic effects of pioglitazone.


RESULTS
The pioglitazone treatment significantly reduced hyperglycemia, hyperinsulinemia, and HbA(1c) levels and increased plasma adiponectin concentrations relative to the control group (P < 0.01). It also significantly decreased CRP and PWV (P < 0.01). The antiatherogenic effect was observed in both the nonresponders showing <1% of reduction in HbA(1c) (n = 30) and responders showing >1% of reduction (n = 40). ANCOVA revealed that treatment with pioglitazone was associated with a low CRP and PWV, independent of the changes in parameters related to glucose metabolism.


CONCLUSIONS
This study represents the first demonstration of the antiatherogenic effect of pioglitazone in both nonresponders and responders with respect to its antidiabetic effect and suggests that pioglitazone can exert its antiatherogenic effect independently of its antidiabetic effect.
Satoh
Noriko
N
Diabetes Center and Clinical Research Institute of Kyoto National Hospital, Kyoto, Japan.
Ogawa
Yoshihiro
Y
Usui
Takeshi
T
Tagami
Tetsuya
T
Kono
Shigeo
S
Uesugi
Hiroko
H
Sugiyama
Hiroyuki
H
Sugawara
Akira
A
Yamada
Kazunori
K
Shimatsu
Akira
A
Kuzuya
Hideshi
H
Nakao
Kazuwa
K
D052242:Adiponectin; D001161:Arteriosclerosis / Q000517:prevention & control*; D001794:Blood Pressure / Q000187:drug effects; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D003925:Diabetic Angiopathies / Q000517:prevention & control*; D005260:Female; D006017:Glycolipids / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D036341:Intercellular Signaling Peptides and Proteins; D007564:Japan; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D000077205:Pioglitazone; D011506:Proteins / Q000378:metabolism; D045162:Thiazolidinediones / Q000627:therapeutic use*
D052242:Adiponectin; D006017:Glycolipids; D007004:Hypoglycemic Agents; D036341:Intercellular Signaling Peptides and Proteins; D020738:Leptin; D011506:Proteins; D045162:Thiazolidinediones; D002097:C-Reactive Protein; D000077205:Pioglitazone