Pioglitazone has anti-inflammatory effects in patients with Type 2 diabetes.
BACKGROUND
Type 2 diabetes is characterized by increased acute phase serum proteins. They are also risk factors for cardiovascular disease. We wanted to study how improvement of glycemic control with pioglitazone or glibenclamide affects their serum concentrations.


METHODS
A total of 59 patients with Type 2 diabetes (age 57.3+/-1.2 yr, glycosylated hemoglobin (HbA1c) 8.3+/-0.7%, body mass index (BMI) 31.4+/-0.8 kg/m2) participated in the study. They were previously treated either with diet alone or in combination with one oral antihyperglycemic medicine. After a 1-week lead-in period on diet only, the patients were randomized to pioglitazone or glibenclamide. Blood samples for alpha-1-acid glycoprotein (A1GP), Creactive protein (CR P) and serum amyloid A (SAA) were taken before the treatments and during the therapy after 20 and 52 weeks.


RESULTS
Baseline A1GP correlated with CR P (r=0.70, p<0.001) and fasting glucose (r=0.32, p<0.02). Baseline CR P correlated with HbA1c (r=0.26, p<0.05) and insulin (r=0.37, p<0.01). The anti-hyperglycemic effect was comparable with HbA1c levels decreasing both in the pioglitazone (from 8.18+/-0.09% to 7.63+/-0.17%, p<0.01) and glibenclamide (from 8.35+/-0.12% to 7.77+/-0.16%, p<0.01) groups. Pioglitazone treatment was associated with a reduction in A1GP at 20 weeks (p<0.001) and at 52 weeks (p<0.05) as compared to baseline. The significance remained also after comparison to glibenclamide therapy (p<0.001 and p<0.05, 20 and 52 weeks respectively). CR P was also more reduced in the pioglitazone group at 20 weeks of treatment (p<0.05).


CONCLUSIONS
Inflammatory factors and markers of hyperglycemia are associated in patients with Type 2 diabetes. Pioglitazone treatment results in reduced A1GP concentration suggesting an anti-inflammatory effect.
Heliövaara
M K
MK
Division of Geriatrics, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland. maikki.heliovaara@hus.fi
Herz
M
M
Teppo
A-M
AM
Leinonen
E
E
Ebeling
P
P
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001786:Blood Glucose / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D005905:Glyburide / Q000627:therapeutic use*; D006442:Glycated Hemoglobin; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009961:Orosomucoid / Q000032:analysis; D000077205:Pioglitazone; D000685:Serum Amyloid A Protein / Q000032:analysis; D045162:Thiazolidinediones / Q000627:therapeutic use*
D000893:Anti-Inflammatory Agents; D001786:Blood Glucose; D002097:C-Reactive Protein; D005905:Glyburide; D006442:Glycated Hemoglobin; D006454:Hemoglobins; D007004:Hypoglycemic Agents; D007328:Insulin; D009961:Orosomucoid; D000077205:Pioglitazone; D000685:Serum Amyloid A Protein; D045162:Thiazolidinediones; C517652:hemoglobin A1c protein, human