The increase in abdominal subcutaneous fat depot is an independent factor to determine the glycemic control after rosiglitazone treatment.
OBJECTIVE
The goal was to investigate the interrelationships between the hypoglycemic effects of rosiglitazone and the changes in the regional adiposity of type 2 diabetic patients.


METHODS
We added rosiglitazone (4 mg/day) to 173 diabetic patients (111 males and 62 females) already taking a stable dose of conventional antidiabetic medications except for thiazolidinediones. The abdominal fat distribution was assessed by ultrasonography at baseline and 12 weeks later. Using ultrasonographic images, the s.c. and visceral fat thickness (SFT and VFT respectively) were measured.


RESULTS
Rosiglitazone treatment for 3 months improved the glycemic control. However, the response to rosiglitazone was no more than 36.4%; the deterioration of the glycemic control was found in 16.8% of subjects. In addition, rosiglitazone treatment significantly increased the body fat mass, especially the s.c. fat. However that did not alter the visceral fat content. The percentage changes in fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) concentrations after treatment were inversely correlated with the increase in SFT (r=-0.327 and -0.353, P<0.001 respectively) and/or body weight (r=-0.316 and -0.327, P<0.001 respectively). Multiple regression analysis revealed that the improvement in the FPG after rosiglitazone treatment was correlated with the baseline FPG (P<0.001) and the change in the SFT (P=0.019), and the reduction in the HbA1c was related with the baseline FPG (P=0.003) and HbA1c (P<0.001) and the changes in the SFT (P=0.010) or VFT (P=0.013).


CONCLUSIONS
The increase in the s.c. fat depot after rosiglitazone treatment may be an independent factor that determines the hypoglycemic efficacy.
Department of Internal Medicine, College of Medicine, Pochon CHA University, Sungnam, South Korea.
Soo-Kyung
SK
Kim
Kyu-Yeon
KY
Hur
Hae-Jin
HJ
Kim
Wan-Sub
WS
Shim
Chul-Woo
CW
Ahn
Seok-Won
SW
Park
Yong-Wook
YW
Cho
Sung-Kil
SK
Lim
Hyun-Chul
HC
Lee
Bong-Soo
BS
Cha
D050153:Abdominal Fat / Q000000981:diagnostic imaging / Q000502:physiology*; D001786:Blood Glucose / Q000378:metabolism*; D001823:Body Composition / Q000502:physiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D050356:Lipid Metabolism / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000627:therapeutic use*; D014463:Ultrasonography
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D000077154:Rosiglitazone; D045162:Thiazolidinediones