title: Rosiglitazone treatment increases subcutaneous adipose tissue glucose uptake in parallel with perfusion in patients with type 2 diabetes: a double-blind, randomized study with metformin.
abstract: BACKGROUND
  We have shown that rosiglitazone increases whole-body and adipose tissue insulin sensitivity in humans.
  
  
  OBJECTIVE
  The aim of this study was to further examine whether possible changes in adipose perfusion could explain increased adipose tissue glucose uptake (GU).
  
  
  METHODS
  Thirty-seven patients with newly diagnosed type 2 diabetes were included.
  
  
  METHODS
  Patients were randomized into treatment with rosiglitazone, metformin, or placebo for 26 wk in a double-blinded trial.
  
  
  METHODS
  Femoral adipose flow and GU were measured with [15O]H2O, [18F]fluorodeoxyglucose and positron emission tomography during euglycemic hyperinsulinemia. Adipose masses were measured using magnetic resonance imaging.
  
  
  RESULTS
  Metformin and rosiglitazone treatment improved glycemic control, but only rosiglitazone increased whole-body insulin sensitivity. Rosiglitazone treatment increased flow by 72% (P < 0.01) and GU by 23% (P < 0.05) and thereby decreased adipose tissue glucose extraction by 18% (P < 0.05); no changes were observed in the metformin or placebo-treated groups. When the adipose masses were taken into account, rosiglitazone treatment increased flow by 73% (P < 0.01) and GU by 24% (P < 0.05). During hyperinsulinemia, flow correlated with GU (r = 0.63; P < 0.01).
  
  
  CONCLUSIONS
  In conclusion, s.c. GU is associated with flow in patients with type 2 diabetes. Rosiglitazone treatment enhances GU and flow but decreases glucose extraction, suggesting that perfusion may contribute to adipose tissue insulin sensitization by rosiglitazone.
authors.affiliation: PET Centre, Turku University Central Hospital, Turku, Finland.
authors.forename: Antti P M
authors.initials: AP
authors.lastname: Viljanen
authors.forename: Kirsi A
authors.initials: KA
authors.lastname: Virtanen
authors.forename: Mikko J
authors.initials: MJ
authors.lastname: Järvisalo
authors.forename: Kirsti
authors.initials: K
authors.lastname: Hällsten
authors.forename: Riitta
authors.initials: R
authors.lastname: Parkkola
authors.forename: Tapani
authors.initials: T
authors.lastname: Rönnemaa
authors.forename: Fredrik
authors.initials: F
authors.lastname: Lönnqvist
authors.forename: Patricia
authors.initials: P
authors.lastname: Iozzo
authors.forename: Ele
authors.initials: E
authors.lastname: Ferrannini
authors.forename: Pirjo
authors.initials: P
authors.lastname: Nuutila
mesh_terms: D000273:Adipose Tissue / Q000098:blood supply / Q000000981:diagnostic imaging / Q000378:metabolism*; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000378:metabolism* / Q000503:physiopathology; D004311:Double-Blind Method; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007333:Insulin Resistance; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D010477:Perfusion; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012039:Regional Blood Flow / Q000187:drug effects; D000077154:Rosiglitazone; D040521:Subcutaneous Tissue / Q000098:blood supply / Q000000981:diagnostic imaging / Q000378:metabolism*; D045162:Thiazolidinediones / Q000627:therapeutic use*
chemical_list: D007004:Hypoglycemic Agents; D019275:Radiopharmaceuticals; D045162:Thiazolidinediones; D000077154:Rosiglitazone; D019788:Fluorodeoxyglucose F18; D008687:Metformin; D005947:Glucose