title: Rosiglitazone improves insulin sensitivity with increased serum leptin levels in patients with type 2 diabetes mellitus.
abstract: Rosiglitazone (RSG) is known to be an agonist for the peroxisome proliferator-activated receptor-gamma (PPARgamma) and promotes differentiation of pre-adipocytes into adipocytes. Leptin is highly correlated with adiposity, while the activation of PPARgamma is known to inhibit Lep gene expression and leptin release. This study was performed to evaluate the relationship between changes in circulating leptin levels, insulin sensitivity and regional adiposity after RSG treatment. Two hundred fifty-one type 2 diabetic patients (176 men and 75 women) who had been treated with sulfonylurea and/or metformin received 4 mg of RSG daily, in addition to the previous medications. Before and after RSG treatment (average duration 5.6+/-0.9 months), indices of insulin resistance, metabolic parameters, and serum leptin and adiponectin levels were measured. Abdominal subcutaneous fat thickness (SFT(max)) and visceral fat thickness were measured by sonography. After RSG treatment, HOMA-IR index decreased significantly (2.82+/-1.94 vs. 2.01+/-1.58), while BMI and SFT(max) increased, and leptin (4.72+/-3.77 vs. 5.69+/-4.30 ng/ml) and adiponectin levels (7.54+/-10.20 vs. 12.89+/-10.13 microg/ml) increased. The increase in serum leptin correlated with an increase in SFT(max) (r=0.511, p<0.001) and with a reduction in HOMA-IR (r=-0.368, p<0.001). The correlation of Delta leptin with Delta HOMA-IR and with Delta SFT(max) was higher in females and among insulin-resistant subjects. In conclusion, RSG improves the insulin sensitivity with increased serum leptin levels in patients with type 2 diabetes mellitus, which is related to an increase in subcutaneous adiposity.
authors.affiliation: Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Hae Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Soo Kyung
authors.initials: SK
authors.lastname: Kim
authors.forename: Wan Sub
authors.initials: WS
authors.lastname: Shim
authors.forename: Jae Hyuk
authors.initials: JH
authors.lastname: Lee
authors.forename: Kyu Yeon
authors.initials: KY
authors.lastname: Hur
authors.forename: Eun Seok
authors.initials: ES
authors.lastname: Kang
authors.forename: Chul Woo
authors.initials: CW
authors.lastname: Ahn
authors.forename: Sung Kil
authors.initials: SK
authors.lastname: Lim
authors.forename: Hyun Chul
authors.initials: HC
authors.lastname: Lee
authors.forename: Bong Soo
authors.initials: BS
authors.lastname: Cha
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; 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*; D007328:Insulin / Q000097:blood / Q000502:physiology; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000627:therapeutic use*; D049629:Waist-Hip Ratio
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D020738:Leptin; D000077154:Rosiglitazone; D045162:Thiazolidinediones