Pioglitazone Decreases Carotid Intima-Media Thickness Independently of Glycemic Control in Patients With Type 2 Diabetes Mellitus

• M.R. Langenfeld

  From the Institute of Clinical Research and Development, Mainz (M.R.L., T.F., C.H., A.P.); Division of Endocrinology and Diabetology, Philipps University Medical School, Marburg (P.K.); Takeda Pharma, Aachen (G.L.); Institut für Stoffwechselforschung, Frankfurt (T.K., S.D.F.); ClinResearch GmbH, Cologne (C.S.); and University of Applied Sciences, Rheinbach (A.P.), Germany.

• T. Forst

  From the Institute of Clinical Research and Development, Mainz (M.R.L., T.F., C.H., A.P.); Division of Endocrinology and Diabetology, Philipps University Medical School, Marburg (P.K.); Takeda Pharma, Aachen (G.L.); Institut für Stoffwechselforschung, Frankfurt (T.K., S.D.F.); ClinResearch GmbH, Cologne (C.S.); and University of Applied Sciences, Rheinbach (A.P.), Germany.

• C. Hohberg

  From the Institute of Clinical Research and Development, Mainz (M.R.L., T.F., C.H., A.P.); Division of Endocrinology and Diabetology, Philipps University Medical School, Marburg (P.K.); Takeda Pharma, Aachen (G.L.); Institut für Stoffwechselforschung, Frankfurt (T.K., S.D.F.); ClinResearch GmbH, Cologne (C.S.); and University of Applied Sciences, Rheinbach (A.P.), Germany.

• P. Kann

  From the Institute of Clinical Research and Development, Mainz (M.R.L., T.F., C.H., A.P.); Division of Endocrinology and Diabetology, Philipps University Medical School, Marburg (P.K.); Takeda Pharma, Aachen (G.L.); Institut für Stoffwechselforschung, Frankfurt (T.K., S.D.F.); ClinResearch GmbH, Cologne (C.S.); and University of Applied Sciences, Rheinbach (A.P.), Germany.

• G. Lübben

  From the Institute of Clinical Research and Development, Mainz (M.R.L., T.F., C.H., A.P.); Division of Endocrinology and Diabetology, Philipps University Medical School, Marburg (P.K.); Takeda Pharma, Aachen (G.L.); Institut für Stoffwechselforschung, Frankfurt (T.K., S.D.F.); ClinResearch GmbH, Cologne (C.S.); and University of Applied Sciences, Rheinbach (A.P.), Germany.

• T. Konrad

  From the Institute of Clinical Research and Development, Mainz (M.R.L., T.F., C.H., A.P.); Division of Endocrinology and Diabetology, Philipps University Medical School, Marburg (P.K.); Takeda Pharma, Aachen (G.L.); Institut für Stoffwechselforschung, Frankfurt (T.K., S.D.F.); ClinResearch GmbH, Cologne (C.S.); and University of Applied Sciences, Rheinbach (A.P.), Germany.

• S.D. Füllert

  From the Institute of Clinical Research and Development, Mainz (M.R.L., T.F., C.H., A.P.); Division of Endocrinology and Diabetology, Philipps University Medical School, Marburg (P.K.); Takeda Pharma, Aachen (G.L.); Institut für Stoffwechselforschung, Frankfurt (T.K., S.D.F.); ClinResearch GmbH, Cologne (C.S.); and University of Applied Sciences, Rheinbach (A.P.), Germany.

• C. Sachara

  From the Institute of Clinical Research and Development, Mainz (M.R.L., T.F., C.H., A.P.); Division of Endocrinology and Diabetology, Philipps University Medical School, Marburg (P.K.); Takeda Pharma, Aachen (G.L.); Institut für Stoffwechselforschung, Frankfurt (T.K., S.D.F.); ClinResearch GmbH, Cologne (C.S.); and University of Applied Sciences, Rheinbach (A.P.), Germany.

• A. Pfützner

  From the Institute of Clinical Research and Development, Mainz (M.R.L., T.F., C.H., A.P.); Division of Endocrinology and Diabetology, Philipps University Medical School, Marburg (P.K.); Takeda Pharma, Aachen (G.L.); Institut für Stoffwechselforschung, Frankfurt (T.K., S.D.F.); ClinResearch GmbH, Cologne (C.S.); and University of Applied Sciences, Rheinbach (A.P.), Germany.

書誌事項

タイトル別名

• Results From a Controlled Randomized Study

抄録

Background— Patients with type 2 diabetes mellitus are at high risk of cardiovascular disease. Carotid intima-media thickness (IMT) is a strong predictor of myocardial infarction and stroke. Methods and Results— We compared the effects of pioglitazone-based therapy (45 mg/d) and glimepiride-based treatment (2.7±1.6 mg/d) for 12 and 24 weeks on metabolic control (HbA 1c ), insulin resistance (homeostasis model assessment), and carotid IMT (B-mode ultrasonography) in a randomized controlled study in 173 orally treated patients with type 2 diabetes (66 women, 107 men; mean±SD age, 62.6±7.9 years; body mass index, 31.8±4.6 kg/m 2 ; HbA 1c , 7.5±0.9%). Treatment was generally well tolerated in both groups. Despite similar improvements in metabolic control (HbA 1c ) after 24 weeks (−0.8±0.9% [pioglitazone] versus −0.6±0.8% [glimepiride]; P =NS), carotid IMT was reduced only in the pioglitazone group after 12 weeks (−0.033±0.052 versus −0.002±0.047 mm [glimepiride]; P <0.01 between groups) and 24 weeks (−0.054±0.059 versus −0.011±0.058 mm [glimepiride]; P <0.005 between groups). Insulin resistance was also improved only in the pioglitazone group (homeostasis model assessment, −2.2±3.4 versus −0.3±3.3; P <0.0001 between groups). Reduction of IMT correlated with improvement in insulin resistance ( r =0.29, P <0.0005) and was independent of improvement in glycemic control ( r =0.03, P =0.68). Conclusions— We found a substantial regression of carotid IMT, independent of improved glycemic control, after 12 and 24 weeks of pioglitazone treatment. This finding may have important prognostic implications for patients with type 2 diabetes mellitus.

収録刊行物

• Circulation

  Circulation 111 (19), 2525-2531, 2005-05-17

  Ovid Technologies (Wolters Kluwer Health)

キーワード

• Physiology (medical)
• Cardiology and Cardiovascular Medicine

詳細情報

• CRID: 1362825894410178304
• NII論文ID: 30022672575
• DOI: 10.1161/01.cir.0000165072.01672.21
• ISSN: 15244539
• ISSN: 00097322
• Web Site: https://www.ahajournals.org/doi/full/10.1161/01.CIR.0000165072.01672.21
• データソース種別:
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  • CiNii Articles