Effect of pioglitazone on energy intake and ghrelin in diabetic patients.
OBJECTIVE
To measure ghrelin and energy intake in the laboratory after pioglitazone treatment.


METHODS
This was a parallel, three-arm study with 51 obese diabetic subjects randomized to either 1) pioglitazone plus a portion-controlled diet (Pio+PC), 2) pioglitazone plus American Diabetes Association (ADA) dietary advice (Pio+ADA), or 3) metformin plus ADA advice (Met+ADA). Energy intake and the suppressive response of a meal on ghrelin were measured at weeks 0 and 16. Mixed models tested if changes from week 0 to 16 differed by group.


RESULTS
The Pio+ADA group had a significantly larger increase (P < 0.05) in energy intake ([adjusted means +/- SE] 207 +/- 53 kcal) compared with the Pio+PC (50 +/- 46 kcal) and Met+ADA (52 +/- 49 kcal) groups. Change in restraint and disinhibition (variables associated with eating behavior) mediated weight change. Ghrelin suppression increased in the Pio+ADA group, which gained weight.


CONCLUSIONS
A portion-controlled diet attenuated the increase in energy intake after pioglitazone. Ghrelin responded to weight change not pioglitazone exposure.
Martin
Corby K
CK
Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA. martinck@pbrc.edu
Gupta
Alok K
AK
Smith
Steven R
SR
Greenway
Frank L
FL
Han
Hongmei
H
Bray
George A
GA
D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000178:diet therapy / Q000188:drug therapy*; D002149:Energy Intake / Q000187:drug effects*; D005260:Female; D054439:Ghrelin / Q000097:blood; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D000077205:Pioglitazone; D045162:Thiazolidinediones / Q000494:pharmacology* / Q000627:therapeutic use*
D054439:Ghrelin; D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D000077205:Pioglitazone