title: The effects of rosiglitazone and metformin on inflammation and endothelial dysfunction in patients with type 2 diabetes mellitus.
abstract: Diabetic patients have a markedly increased risk of cardiovascular disease compared with non-diabetics. Two drug groups today target insulin resistance; biguanides and thiazolidinediones. In addition, these may have other effects on cardiovascular risk factors. The aim of this study was to evaluate the effects of metformin and rosiglitazone on non-traditional cardiovascular risk factors. Forty type 2 diabetic patients were randomized into metformin and rosiglitazone groups. After receiving the optimal doses, the patients were monitored for 12 weeks. Biochemical parameters, lipid parameters, CRP, insulin, c-peptide, and HbA1c levels were analyzed. VWF, PAI-1, ICAM-1, TNF-α, IL-6, E-selectin, and fibrinogen levels were measured in order to assess coagulation status and endothelial dysfunction. In the metformin group, body mass index, PPG, HbA1c, IL-6, ICAM-1, and TNF-α levels were significantly decreased after 12 weeks compared with the basal levels. IL-6 levels decreased from 75 pg/ml ± 20 to 42 pg/ml ± 9 (P 0.023) and TNF- α levels from 61 pg/ml ± 31 to 39 pg/ml ± 10 (P 0.018). In the rosiglitazone group, FPG, PPG, HbA1c, insulin, HOMA-IR, IL-6, and TNF-α levels decreased significantly after 12 weeks compared with the basal levels. IL-6 levels decreased from 78 pg/ml ± 21 to 41 pg/ml ± 9 (P 0.028) and TNF-α levels from 62 pg/ml ± 19 to 37 pg/ml ± 10 (P 0.012). At the end of the study, no significant differences were determined between groups. Insulin resistance and type 2 diabetes are strongly associated with low grade inflammation. Both metformin and rosiglitazone were effective in controlling inflammatory markers in addition to metabolic parameters.
authors.affiliation: Department of Internal Medicine and Medical Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, 61080, Turkey. evrenfidan@yahoo.com.
authors.forename: Evren
authors.initials: E
authors.lastname: Fidan
authors.affiliation: Division of Endocrinology and Metabolism, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Onder Ersoz
authors.affiliation: Division of Hematology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yilmaz
authors.affiliation: Department of Biochemistry,Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
authors.forename: Hulya
authors.initials: H
authors.lastname: Yilmaz
authors.affiliation: Division of Endocrinology and Metabolism, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kocak
authors.affiliation: Department of Biochemistry,Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
authors.forename: Caner
authors.initials: C
authors.lastname: Karahan
authors.affiliation: Division of Endocrinology and Metabolism, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
authors.forename: Cihangir
authors.initials: C
authors.lastname: Erem
mesh_terms: D000328:Adult; D002096:C-Peptide / Q000276:immunology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000276:immunology* / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy* / Q000378:metabolism; D042783:Endothelial Cells / Q000187:drug effects / Q000276:immunology*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000276:immunology; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000627:therapeutic use*; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology
chemical_list: D002096:C-Peptide; D015850:Interleukin-6; D045162:Thiazolidinediones; D014409:Tumor Necrosis Factor-alpha; D000077154:Rosiglitazone; D008687:Metformin