title: Determinants of an optimal response to pioglitazone in terms of HDL-cholesterol.
abstract: OBJECTIVE
  The effect of pioglitazone on high-density lipoprotein cholesterol (HDL-C) has been attracting attention. However, there are limited data on the characteristics of patients who are likely to respond to pioglitazone in terms of the improvement in HDL-C levels (lipid responders). In the present study, the characteristics of lipid responders were investigated.
  
  
  METHODS
  Five hundred and sixty-three patients with type 2 diabetes who started pioglitazone treatment were followed for six months. They were divided into two groups according to the response to pioglitazone. Subjects whose HDL-C levels increased by 10% or more from the baseline were defined as lipid responders. The odds ratios (OR) for becoming lipid responders were calculated using logistic regression.
  
  
  RESULTS
  Significant patients' characteristics of lipid responders were age, HbA1c, HDL-C and low-density lipoprotein cholesterol (LDL-C), yielding adjusted ORs of 0.76 [95% confidence interval (CI)=0.61-0.93] for an increment of 10 years, 0.79 (95% CI=0.66-0.95) for an increment of 1%, 0.83 (95% CI=0.72-0.96) for an increment of 10 mg/dL and 0.93 (95% CI=0.87-1.00) for an increment of 10 mg/dL, respectively. Patients with sulfonylurea treatment and those with both sulfonylurea and metformin treatment were less likely to become lipid responders than diet-treated patients with ORs of 0.32 (95% CI=0.15-0.69) and 0.41 (95% CI=0.19-0.87), respectively.
  
  
  CONCLUSIONS
  Pioglitazone could be beneficial especially for patients with young age, low HbA1c, low HDL-C or low LDL-C levels at baseline in terms of the improvement in HDL-C levels. Use of sulfonylureas at baseline could attenuate the effect of pioglitazone on HDL-C.
authors.affiliation: Department of Internal Medicine, Saiseikai Central Hospital, Japan. ykabeyan@yahoo.co.jp
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kabeya
authors.forename: Masuomi
authors.initials: M
authors.lastname: Tomita
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Asai
authors.forename: Takeshi
authors.initials: T
authors.lastname: Katsuki
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Oikawa
authors.forename: Shu
authors.initials: S
authors.lastname: Meguro
authors.forename: Akira
authors.initials: A
authors.lastname: Shimada
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Atsumi
mesh_terms: D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy*; D004347:Drug Interactions; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D050356:Lipid Metabolism / Q000187:drug effects; D008297:Male; D008687:Metformin / Q000008:administration & dosage; D008875:Middle Aged; D000077205:Pioglitazone; D013453:Sulfonylurea Compounds / Q000008:administration & dosage; D045162:Thiazolidinediones / Q000008:administration & dosage / Q000627:therapeutic use*; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D008687:Metformin; D000077205:Pioglitazone; D013453:Sulfonylurea Compounds; D045162:Thiazolidinediones; D014280:Triglycerides; C517652:hemoglobin A1c protein, human