The effects of pioglitazone and metformin on plasma visfatin levels in patients with treatment naive type 2 diabetes mellitus.
OBJECTIVE
Circulating visfatin levels are altered in insulin resistant states. We evaluated the effects of two insulin-sensitizing hypoglycemic agents on plasma visfatin and adiponectin levels in patients with newly diagnosed and untreated type 2 diabetes mellitus (T2DM).


METHODS
Forty-four patients with T2DM were randomized to treatment either with pioglitazone (15-45mg/day) or metformin (1000-2000mg/day). Plasma visfatin and adiponectin levels and homeostasis model assessment of insulin resistance (HOMA-IR) scores were determined at baseline and at 12th week of treatment.


RESULTS
By the end of the 12th week, fasting plasma glucose, HbA1c, HOMA-IR scores and waist circumferences improved equally in both treatment arms. HDL cholesterol and adiponectin levels increased only in the pioglitazone group (p=0.01 and p=0.003, respectively). On the other hand, metformin treatment had additional regulatory effects on BMI, blood pressure and total and LDL-cholesterol levels (p=0.002, p=0.01, p=0.004, p=0.001 and p<0.001, respectively). Neither pioglitazone nor metformin displayed a significant effect on circulating visfatin concentration.


CONCLUSIONS
Despite improvements in insulin sensitivity and glycemic regulation, either pioglitazone or metformin treatment did not result in any effect on blood visfatin levels in patients with treatment naïve T2DM.
Erdem
Gokhan
G
Department of Internal Medicine, Gulhane School of Medicine, GATA Ic Hastaliklari B.D., Etlik 06018, Ankara, Turkey.
Dogru
Teoman
T
Tasci
Ilker
I
Bozoglu
Ergun
E
Muhsiroglu
Ozlem
O
Tapan
Serkan
S
Ercin
Cemal Nuri
CN
Sonmez
Alper
A
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007333:Insulin Resistance; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D054409:Nicotinamide Phosphoribosyltransferase / Q000097:blood*; D000077205:Pioglitazone; D045162:Thiazolidinediones / Q000627:therapeutic use*; D055105:Waist Circumference / Q000187:drug effects
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D008687:Metformin; D054409:Nicotinamide Phosphoribosyltransferase; D000077205:Pioglitazone; D045162:Thiazolidinediones