Pioglitazone and Rosiglitazone Have Different Effects on Serum Lipoprotein Particle Concentrations and Sizes in Patients With Type 2 Diabetes and Dyslipidemia

  1. Mark A. Deeg, MD1,
  2. John B. Buse, MD2,
  3. Ronald B. Goldberg, MD3,
  4. David M. Kendall, MD4,
  5. Anthony J. Zagar, MS5,
  6. Scott J. Jacober, DO5,
  7. Mehmood A. Khan, MD6,
  8. Alfonzo T. Perez, MD7,
  9. Meng H. Tan, MD5 and
  10. on behalf of the GLAI Study Investigators*
  1. 1Department of Endocrinology and Metabolism, Veterans Affairs Hospital and Indiana University, Indianapolis, Indiana
  2. 2Department of Endocrinology and General Medicine, University of North Carolina, Chapel Hill, North Carolina
  3. 3Department of Endocrinology, Metabolism and Diabetes, University of Miami, Miami, Florida
  4. 4International Diabetes Center, Park Nicollet Institute, Minneapolis, Minnesota
  5. 5Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana
  6. 6Takeda Pharmaceuticals North America, Lincolnshire, Illinois
  7. 7Takeda Global Research and Development, Lincolnshire, Illinois
  1. Address correspondence and reprint requests to Meng H. Tan, MD, Lilly Research Laboratory, Eli Lilly and Company, Indianapolis, IN 46285. E-mail: tan_meng{at}lilly.com

Abstract

OBJECTIVE—Associated with insulin resistance in type 2 diabetes are increased serum triglycerides, decreased HDL cholesterol, and a predominance of large VLDL, small LDL, and small HDL particles. The comparative effects of thiazolidinedione insulin sensitizers on serum lipoprotein particle concentrations and sizes in type 2 diabetes are not known. We studied the effects of pioglitazone (PIO) and rosiglitazone (ROSI) treatments on serum lipoprotein particle concentrations and sizes in type 2 diabetic patients with dyslipidemia.

RESEARCH DESIGN AND METHODS—This is a prospective, randomized, double-blind, multicenter, parallel-group study. After a 4-week placebo washout period, patients randomized to PIO (n = 369) were treated with 30 mg q.d. for 12 weeks followed by 45 mg q.d. for another 12 weeks, while patients randomized to ROSI (n = 366) were treated with 4 mg q.d. followed by 4 mg b.i.d. for the same intervals. Lipoprotein subclass particle concentrations and sizes were determined by proton nuclear magnetic resonance spectroscopy at baseline and end point (PIO [n = 333] and ROSI [n = 325] patients).

RESULTS—PIO treatment increased total VLDL particle concentration less than ROSI treatment and decreased VLDL particle size more than ROSI. PIO treatment reduced total LDL particle concentration, whereas ROSI treatment increased it. Both treatments increased LDL particle size, with PIO treatment having a greater effect. Whereas PIO treatment increased total HDL particle concentration and size, ROSI treatment decreased them; both increased HDL cholesterol levels.

CONCLUSIONS—PIO and ROSI treatments have different effects on serum lipoprotein subclass particle concentrations and sizes in patients with type 2 diabetes and dyslipidemia.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 26 June 2007. DOI: 10.2337/dc06-1903. Clinical trial reg. no. NCT00331487, clinicaltrials.org.

  • *

    ↵* A complete list of the GLAI Study Investigators can be found in the appendix.

  • D.M.K is currently affiliated with Amylin Pharmaceuticals, San Diego, California.

    M.A.D. has received honoraria from Takeda. J.B.B. has received consulting fees from Eli Lilly, LipoScience, Lilly, and Takeda. R.B.G. has received honoraria from Lilly, Takeda, Pfizer, Merck, Merck Schering Plough, KOS, Astra Zeneca, and Abbott; has received grant/research support from Novo Nordisk, Pfizer, Merck, KOS, Astra Zeneca, and Sankyo; and has received consulting fees from Lilly and Takeda, Pfizer, Merck, Merck Schering Plough, Astra Zeneca, and Abbott.

    A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    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.

    • Accepted June 18, 2007.
    • Received September 12, 2006.
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  1. Published online before print June 26, 2007, doi: 10.2337/dc06-1903 Diabetes Care October 2007 vol. 30 no. 10 2458-2464
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