Antiatherogenic Effect of Pioglitazone in Type 2 Diabetic Patients Irrespective of the Responsiveness to Its Antidiabetic Effect

  • Noriko Satoh
    Diabetes Center and Clinical Research Institute of Kyoto National Hospital, Kyoto, Japan
  • Yoshihiro Ogawa
    Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, Kyoto, Japan
  • Takeshi Usui
    Diabetes Center and Clinical Research Institute of Kyoto National Hospital, Kyoto, Japan
  • Tetsuya Tagami
    Diabetes Center and Clinical Research Institute of Kyoto National Hospital, Kyoto, Japan
  • Shigeo Kono
    Diabetes Center and Clinical Research Institute of Kyoto National Hospital, Kyoto, Japan
  • Hiroko Uesugi
    Department of Internal Medicine, Saiseikai Noe Hospital, Osaka, Japan
  • Hiroyuki Sugiyama
    Department of Internal Medicine, Saiseikai Noe Hospital, Osaka, Japan
  • Akira Sugawara
    Diabetes Center and Clinical Research Institute of Kyoto National Hospital, Kyoto, Japan
  • Kazunori Yamada
    Diabetes Center and Clinical Research Institute of Kyoto National Hospital, Kyoto, Japan
  • Akira Shimatsu
    Diabetes Center and Clinical Research Institute of Kyoto National Hospital, Kyoto, Japan
  • Hideshi Kuzuya
    Diabetes Center and Clinical Research Institute of Kyoto National Hospital, Kyoto, Japan
  • Kazuwa Nakao
    Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, Kyoto, Japan

抄録

<jats:p>OBJECTIVE—Thiazolidinediones (TZDs), a class of insulin-sensitizing agents used clinically to treat type 2 diabetes, are also antiatherogenic. This study was designed to elucidate the relationship between the antiatherogenic and antidiabetic effects of pioglitazone, a TZD, in type 2 diabetic patients.</jats:p> <jats:p>RESEARCH DESIGN AND METHODS—A total of 136 Japanese type 2 diabetic patients were included and divided into two groups: the pioglitazone-treated group (30 mg daily for 3 months) (n = 70) and the untreated control group (n = 66). The changes in glycolipid metabolism as well as plasma high-sensitivity C-reactive protein (CRP), leptin, adiponectin, and pulse wave velocity (PWV) were monitored to analyze the relationship between the antiatherogenic and antidiabetic effects of pioglitazone.</jats:p> <jats:p>RESULTS—The pioglitazone treatment significantly reduced hyperglycemia, hyperinsulinemia, and HbA1c levels and increased plasma adiponectin concentrations relative to the control group (P &lt; 0.01). It also significantly decreased CRP and PWV (P &lt; 0.01). The antiatherogenic effect was observed in both the nonresponders showing &lt;1% of reduction in HbA1c (n = 30) and responders showing &gt;1% of reduction (n = 40). ANCOVA revealed that treatment with pioglitazone was associated with a low CRP and PWV, independent of the changes in parameters related to glucose metabolism.</jats:p> <jats:p>CONCLUSIONS—This study represents the first demonstration of the antiatherogenic effect of pioglitazone in both nonresponders and responders with respect to its antidiabetic effect and suggests that pioglitazone can exert its antiatherogenic effect independently of its antidiabetic effect.</jats:p>

収録刊行物

  • Diabetes Care

    Diabetes Care 26 (9), 2493-2499, 2003-09-01

    American Diabetes Association

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