Effects of pioglitazone on subclinical atherosclerosis and insulin resistance in nondiabetic renal allograft recipients.
BACKGROUND
The aim of this study was to evaluate the effect of pioglitazone treatment on the progression of subclinical atherosclerosis and insulin resistance in renal allograft recipients with no preoperative history of diabetes.


METHODS
Eighty-three patients without diabetes were randomly assigned to either the pioglitazone group or the control group. Carotid intima-media thickness (IMT), serum adiponectin level and lipid profile were assessed before transplantation and at 12 months after transplantation. Insulin secretory function and insulin resistance were evaluated by the oral glucose tolerance test.


RESULTS
The pioglitazone group showed a significant reduction in the mean and maximum carotid IMT compared with the control group after 12 months (mean carotid IMT, 0.05 +/- 0.04 vs -0.03 +/- 0.07 mm, P < 0.001; maximum carotid IMT, 0.08 +/- 0.05 vs -0.05 +/- 0.09 mm, P < 0.001). Pioglitazone increased the adiponectin level, and the change in adiponectin was negatively correlated with carotid IMT changes. Pioglitazone treatment increased the insulin sensitivity index compared with the control group (-0.8 +/- 3.1x10(-)(2) vs +1.1 +/- 3.7x10(-)(2), P = 0.036).


CONCLUSIONS
These results suggest that pioglitazone treatment reduces the progression of carotid IMT and improves insulin resistance in renal allograft recipients without a history of diabetes. Trial Registration. Clinicaltrials.gov Identifier: NCT00598013.
Han
Seung Jin
SJ
Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon 443-721, Korea.
Hur
Kyu Yeon
KY
Kim
Yu Seun
YS
Kang
Eun Seok
ES
Kim
Soon Il
SI
Kim
Myoung Soo
MS
Kwak
Jung Young
JY
Kim
Dae Jung
DJ
Choi
Sung Hee
SH
Cha
Bong Soo
BS
Lee
Hyun Chul
HC
D052242:Adiponectin / Q000097:blood; D000328:Adult; D050197:Atherosclerosis / Q000188:drug therapy* / Q000503:physiopathology; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D018450:Disease Progression; D005260:Female; D018149:Glucose Intolerance / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D007333:Insulin Resistance / Q000502:physiology*; D016030:Kidney Transplantation / Q000502:physiology*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D000077205:Pioglitazone; D045162:Thiazolidinediones / Q000494:pharmacology / Q000627:therapeutic use*; D014184:Transplantation, Homologous; D014463:Ultrasonography
D052242:Adiponectin; D007004:Hypoglycemic Agents; D008055:Lipids; D045162:Thiazolidinediones; D000077205:Pioglitazone