Primary pioglitazone failure in Asian Indian diabetics is not related to common Pro12Ala polymorph of PPAR-gamma gene.
To determine the various factors influencing glycemic response to pioglitazone monotherapy in newly diagnosed Asian Indian T2DM patients. Thirty T2DM patients (age 53.23 +/- 8.067 yrs, M: F ratio 14:16) were treated with pioglitazone for at least 14 weeks. Relationship between its glucose lowering effect and following patient parameters was studied: BMI, W:H ratio, HOMA-R, HOMA-beta and Pro12Ala polymorph of PPAR-gamma gene. Glycemic targets could be achieved in 20 (66.67%) subjects. All the parameters were comparable among responders and non-responders at the start of therapy. All the participants were homozygous for Pro allele of Pro12Ala polymorph of PPAR-gamma gene. There was a significant positive association between glycemic response to pioglitazone and W: H ratio (beta = 0.426, P = 0.034) and HOMA-R (beta = 0.563, P = 0.008). Primary pioglitazone failure cannot be explained on the basis of body fat and its distribution, insulin resistance and secretory function and Pro12Ala polymorph of PPAR-gamma gene. Among responders central obesity and high insulin resistance were associated with better glycemic response.
Mathur
Sandeep K
SK
Clinical Endocrinology Unit, S. M. S. Medical College, J. L. N. Marg, Jaipur - 302 004. drsandeepmathur@rediffmail.com
Rathore
Rajkumar
R
Chandra
Shivani
S
Sharma
B B
BB
Sharma
Lokender
L
Mathur
Prashant
P
Mathur
Mukul
M
D044466:Asian People / Q000235:genetics*; D001786:Blood Glucose / Q000187:drug effects; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000208:ethnology / Q000235:genetics; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006720:Homozygote; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D047495:PPAR gamma / Q000819:agonists* / Q000235:genetics*; D010865:Pilot Projects; D000077205:Pioglitazone; D011110:Polymorphism, Genetic; D045162:Thiazolidinediones / Q000627:therapeutic use*; D013997:Time Factors; D017211:Treatment Failure; D049629:Waist-Hip Ratio
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D047495:PPAR gamma; D000077205:Pioglitazone; D045162:Thiazolidinediones; C517652:hemoglobin A1c protein, human