Pioglitazone and Rosiglitazone Have Different Effects on Serum Lipoprotein Particle Concentrations and Sizes in Patients with Type 2 Diabetes and Dyslipidemia
- Mark A. Deeg, MD1,
- John B. Buse, MD2,
- Ronald B. Goldberg, MD3,
- David M. Kendall, MD4,
- Anthony J. Zagar, MS5,
- Scott J. Jacober, DO5,
- Mehmood A. Khan, MD6,
- Alfonzo T. Perez, MD7 and
- Meng H. Tan, MD (tan_meng{at}lilly.com)5 on behalf of the GLAI Study Investigators
- 1Endocrinology and Metabolism, Veterans Affairs Hospital and Indiana University, Indianapolis, Indiana;
- 2Endocrinology and General Medicine, University of North Carolina, Chapel Hill, North Carolina;
- 3Endocrinology, Metabolism and Diabetes, University of Miami, Miami, Florida;
- 4International Diabetes Center, Park Nicollet Institute, Minneapolis, Minnesota;
- 5Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana;
- 6Takeda Pharmaceuticals North America, Lincolnshire, Illinois;
- 7Takeda Global Research and Development, Lincolnshire, Illinois
Abstract
Objective: Associated with insulin resistance in type 2 diabetes are increased serum triglycerides, decreased HDL-C, 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 diabetes patients with dyslipidemia.
Research Design and Methods: This is a prospective, randomized, double-blind, multi-center, parallel-group study. After a 4-week placebo washout period, patients randomized to PIO (n=369) were treated with 30 mg qd for 12 weeks followed by 45 mg qd for another 12 weeks, while patients randomized to ROSI (n=366) were treated with 4 mg qd followed by 4 mg bid for the same intervals. Lipoprotein subclass particle concentrations and sizes were determined by proton nuclear magnetic resonance spectroscopy at baseline and endpoint (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.
Conclusion: PIO and ROSI treatments have different effects on serum lipoprotein subclass particle concentrations and sizes in patients type 2 diabetes and dyslipidemia.
Conclusion: Registered in clinicaltrials.gov as NCT00331487
Footnotes
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- Received September 12, 2006.
- Accepted June 18, 2007.
- Copyright © American Diabetes Association
