Effect of Rosiglitazone and Insulin Combination Therapy on Inflammation Parameters and Adipocytokine Levels in Patients with Type 1 DM.
OBJECTIVE
To investigate the efficacy of combined therapy of insulin and rosiglitazone on metabolic and inflammatory parameters, insulin sensitivity, and adipocytokine levels in patients with type 1 diabetes mellitus (type 1 DM).


METHODS
A total of 61 adults with type 1 DM were randomly and prospectively assigned in open-label fashion to take insulin and rosiglitazone 4 mg/day (n = 30) or insulin alone (n = 31) for a period of 18 weeks while undergoing insulin therapy without acute metabolic complications.


RESULTS
Combination therapy did not significantly improve metabolic and inflammatory parameters, insulin sensitivity, and adiponectin levels. While leptin and resistin levels decreased in both groups (group 1: resistin 6.96 ± 3.06 to 4.99 ± 2.64, P = 0.006; leptin 25.8 ± 17.6 to 20.1 ± 12.55, P = 0.006; group 2: resistin 7.16 ± 2.30 to 5.57 ± 2.48, P = 0.031; leptin 16.72 ± 16.1 to 14.0 ± 13.4, P = 0.007) Hgb and fibrinogen levels decreased only in group 1 (Hgb 13.72 ± 1.98 to 13.16 ± 1.98, P = 0.015, and fibrinogen 4.00 ± 1.08 to 3.46 ± 0.90, P = 0.002). Patients in both groups showed weight gain and the incidence of hypoglycemia was not lower.


CONCLUSIONS
The diverse favorable effects of TZDs were not fully experienced in patients with type 1 DM. These results are suggesting that insulin sensitizing and anti-inflammatory characteristics of TZDs were likely to be more pronounced in patients who were not totally devoid of endogenous insulin secretion.
Division of Endocrinology, Sevket Yılmaz Research and Education Hospital, 16310 Bursa, Turkey ; Department of Endocrinology and Metabolism, School of Medicine, Uludağ University, 16210 Bursa, Turkey.
Metin
M
Guclu
Department of Endocrinology and Metabolism, School of Medicine, Uludağ University, 16210 Bursa, Turkey.
Ozen
O
Oz Gul
Division of Endocrinology, Sevket Yılmaz Research and Education Hospital, 16310 Bursa, Turkey ; Department of Endocrinology and Metabolism, School of Medicine, Uludağ University, 16210 Bursa, Turkey.
Soner
S
Cander
Department of Endocrinology and Metabolism, School of Medicine, Uludağ University, 16210 Bursa, Turkey ; Acibadem Private Hospital, 16210 Bursa, Turkey.
Oguzkaan
O
Unal
Department of Biostatistics, School of Medicine, Uludağ University, 16210 Bursa, Turkey.
Guven
G
Ozkaya
Department of Biochemistry, School of Medicine, Uludağ University, 16210 Bursa, Turkey.
Emre
E
Sarandol
Department of Endocrinology and Metabolism, School of Medicine, Uludağ University, 16210 Bursa, Turkey.
Canan
C
Ersoy
D054392:Adipokines / Q000097:blood*; D052242:Adiponectin / Q000378:metabolism; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy; D004359:Drug Therapy, Combination; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000097:blood; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007249:Inflammation / Q000188:drug therapy*; D007328:Insulin / Q000008:administration & dosage* / Q000378:metabolism; D000078790:Insulin Secretion; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D052243:Resistin / Q000097:blood; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000008:administration & dosage*; D055815:Young Adult
D054392:Adipokines; D052242:Adiponectin; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D020738:Leptin; D052243:Resistin; D045162:Thiazolidinediones; D000077154:Rosiglitazone; D005340:Fibrinogen