Pioglitazone improves endothelial and adipose tissue dysfunction in pre-diabetic CAD subjects.
OBJECTIVE
To investigate the effect of pioglitazone on endothelial and adipose tissue dysfunction in newly detected IGT patients with CAD.


METHODS
Participants (n=25) were randomized to treatment with either placebo or pioglitazone (30 mg/day) for 12 weeks. Before and after treatment we evaluated endothelial function (flow-mediated dilation--FMD--of the brachial artery), circulating adipose and inflammatory markers (adiponectin isoforms, TNF-alpha, and high sensitivity-CRP), and insulin sensitivity (euglycemic hyperinsulinemic clamp).


RESULTS
No significant changes were observed in subjects (n=12) treated with placebo. By contrast, subjects (n=13) treated with pioglitazone had significant improvement in FMD (10.8±5.3 vs 13.3±3.6%, p<0.01), accompanied by increased high molecular weight adiponectin (HMW-Ad) (1.7±1.2 vs 4.8±3.6 μg/ml, p<0.05) and decreased TNF-alpha (4.3±1.9 vs 3.2±1.2 pg/ml, p<0.05) associated to an increased glucose disposal (4.8±1.9 vs 5.4±2.0 mg kg(-1) min(-1), p<0.05). A multiple regression analysis indicated that increasing of HMW-Ad after pioglitazone predicted increased FMD.


CONCLUSIONS
Pioglitazone significantly improves endothelial and adipose tissue dysfunction in pre-diabetic patients with CAD.
Department of Internal Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy.
Stefano
S
Rizza
Marina
M
Cardellini
Ottavia
O
Porzio
Chiara
C
Pecchioli
Alessia
A
Savo
Iris
I
Cardolini
Nicoletta
N
Senese
Davide
D
Lauro
Paolo
P
Sbraccia
Renato
R
Lauro
Massimo
M
Federici
D052242:Adiponectin / Q000378:metabolism; D000273:Adipose Tissue / Q000187:drug effects* / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D000077205:Pioglitazone; D011236:Prediabetic State / Q000188:drug therapy*; D045162:Thiazolidinediones / Q000627:therapeutic use*
D052242:Adiponectin; D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D000077205:Pioglitazone