Effect of Rosiglitazone on Endothelial Function and Inflammatory Markers in Patients With the Metabolic Syndrome
- Katherine Esposito, MD, PHD12,
- Miryam Ciotola, MD1,
- Diego Carleo, MD1,
- Bruno Schisano, BT1,
- Franco Saccomanno, MD1,
- Ferdinando Carlo Sasso, MD3,
- Domenico Cozzolino, MD3,
- Roberta Assaloni, MD4,
- Domenico Merante, MD5,
- Antonio Ceriello, MD4 and
- Dario Giugliano, MD, PHD12
- 1Division of Metabolic Diseases, University of Naples SUN, Naples, Italy
- 2Centro di Eccellenza Cardiovascolare, University of Naples SUN, Naples, Italy
- 3Department of Geriatrics and Metabolic Diseases, University of Naples SUN, Naples, Italy
- 4Department of Internal Medicine, University of Udine, Udine, Italy
- 5Medical Department, GlaxoSmithKline, Verona, Italy
- Address correspondence and reprint requests to Dario Giugliano, MD, PhD, Chair and Division of Metabolic Diseases, Policlinico Seconda Università di Napoli, Piazza L. Miraglia, 80031 Naples, Italy. E-mail: dario.giugliano{at}unina2.it
Abstract
OBJECTIVE—The aim of this study was to assess the effect of rosiglitazone on endothelial function and inflammatory markers in patients with the metabolic syndrome.
RESEARCH DESIGN AND METHODS—This was a randomized, double-blind, controlled clinical trial. One hundred subjects (54 men and 46 women) with the metabolic syndrome, as defined by the Adult Treatment Panel III, were followed for 12 months after random assignment to rosiglitazone (4 mg/day) or placebo. Primary end points were flow-mediated dilation and high-sensitivity C-reactive protein (hs-CRP) levels; secondary end points were lipid and glucose parameters, homeostasis model assessment (HOMA) of insulin sensitivity, endothelial function score, and circulating levels of interleukin (IL)-6, IL-18, and adiponectin.
RESULTS—Compared with 60 control subjects matched for age and sex, patients with the metabolic syndrome had decreased endothelial function, raised concentrations of inflammatory markers, and reduced insulin sensitivity. After 12 months, subjects with the metabolic syndrome receiving rosiglitazone showed improved flow-mediated vasodilation (4.2%, P < 0.001) and reduced hs-CRP levels (−0.7 mg/dl, P = 0.04), compared with the placebo group. Moreover, HOMA (−0.8, P = 0.01) and serum concentrations of IL-6 (−0.5 pg/ml, P = 0.045) and IL-18 (−31 pg/ml, P = 0.036) were significantly reduced in subjects receiving rosiglitazone, whereas adiponectin levels showed a significant increment (2.3 μg/ml, P = 0.02). High-density lipoprotein-cholesterol levels increased more and triglyceride levels decreased more in the rosiglitazone group compared with the placebo group. At 1 year of follow-up, 30 subjects receiving rosiglitazone still had features of the metabolic syndrome, compared with 45 subjects receiving placebo (P < 0.001).
CONCLUSIONS—Rosiglitazone might be effective in reducing the prevalence of the metabolic syndrome.
- CRP, C-reactive protein
- FMD, flow-mediated vasodilation
- HOMA, homeostasis model assessment
- hs-CRP, high-sensitivity CRP
- IL, interleukin
Footnotes
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A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Accepted January 25, 2006.
- Received November 8, 2005.
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