Pioglitazone plus a sulphonylurea or metformin is associated with increased lipoprotein particle size in patients with type 2 diabetes.
OBJECTIVE
To determine the effect of pioglitazone plus metformin or a sulphonylurea on lipoprotein particle size and subclass distribution in patients with type 2 diabetes.


METHODS
Lipid profiles were determined for blood samples from patients participating in two randomised, double-blind, 24-week studies of pioglitazone 30 mg or 45 mg daily plus either metformin or a sulphonylurea.


RESULTS
Samples from 177 patients were evaluated; 96 of these patients received a sulphonylurea, and 81 received metformin. Pioglitazone combination treatment produced significant increases from baseline for average and peak low-density lipoprotein (LDL) particle size at weeks 12 and 24 (p<0.0001 for each; range 0.29-0.39 nm for average and 0.36-0.55 nm for peak particle size, respectively). Significant shifts in high-density lipoprotein (HDL) and LDL distribution showed an increase in large particles and a decrease in small particles. For pioglitazone plus metformin, significant increases in levels of apolipoprotein (Apo) Al, Apo Al/All-containing HDL, and lipoprotein(a) also were noted, whereas Apo B levels decreased.


CONCLUSIONS
These observed changes are thought to affect the atherogenic profile positively. Therefore, pioglitazone combination treatment may lead to decreased cardiovascular risk in patients with type 2 diabetes.
Perez
Alfonso
A
Takeda Global Research and Development, Inc., 475 Half Day Road, Suite 500, Lincolnshire, IL 60069, USA. diabetespubs@tpna.com
Khan
Mehmood
M
Johnson
Todd
T
Karunaratne
Mahinda
M
D002318:Cardiovascular Diseases / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D017270:Lipoprotein(a) / Q000097:blood; D008075:Lipoproteins, HDL / Q000097:blood / Q000737:chemistry; D008077:Lipoproteins, LDL / Q000097:blood* / Q000737:chemistry; D008297:Male; D008687:Metformin / Q000008:administration & dosage / Q000627:therapeutic use*; D010316:Particle Size; D000077205:Pioglitazone; D013453:Sulfonylurea Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D045162:Thiazolidinediones / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors
D007004:Hypoglycemic Agents; D017270:Lipoprotein(a); D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D013453:Sulfonylurea Compounds; D045162:Thiazolidinediones; D008687:Metformin; D000077205:Pioglitazone