Long-term effects of pioglitazone versus gliclazide on hepatic and humoral coagulation factors in patients with type 2 diabetes.
This study compared the long-term effects of pioglitazone and gliclazide on the production of coagulation factors in patients with type 2 diabetes. Patients (n=283) with glycosylated haemoglobin > 7.5% were randomised to receive either pioglitazone (30-45 mg/day) or gliclazide (80-320 mg/day) for one year. Coagulation factors were measured at baseline and at six and 12 months. While both pioglitazone and gliclazide induced a comparable improvement in glycaemic control, only pioglitazone improved insulin sensitivity. Pioglitazone significantly (p < or = 0.001) decreased circulating levels of von Willebrand factor (-9.7%, -9.4%) and plasminogen activator inhibitor-1 (-16.8 ng/ml, -12.3 ng/ml), and increased levels of antithrombin-III (+1.3 mg/dL, +1.5 mg/dL) after six and 12 months, respectively. The beneficial effects of pioglitazone on glycaemic control, lipid homeostasis, and coagulation and thrombosis, may improve vascular outcomes in patients with type 2 diabetes.
Perriello
Gabriele
G
Section of Internal Medicine, Endocrinology and Metabolism, Department of Internal Medicine, University of Perugia, Perugia, Italy. gabriele@dimisem.med.unipg.it
Pampanelli
Simone
S
Brunetti
Paolo
P
di Pietro
Cinzia
C
Mariz
Segundo
S
D000328:Adult; D000368:Aged; D001779:Blood Coagulation Factors / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005907:Gliclazide / Q000627:therapeutic use*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008099:Liver / Q000187:drug effects / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D000077205:Pioglitazone; D045162:Thiazolidinediones / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
D001779:Blood Coagulation Factors; D005907:Gliclazide; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D000077205:Pioglitazone; D045162:Thiazolidinediones