Antiatherogenic Effect of Pioglitazone in Type 2 Diabetic Patients Irrespective of the Responsiveness to Its Antidiabetic Effect
Article Figures & Tables
Figures
- Figure 1—
A and B: Plasma CRP levels and PWV in the control and pioglitazone-treated groups before and at the end of this study. Each column and bar represents the mean ± SEM before (B) and after 3 months (A). **P < 0.01. C and D: Plasma CRP levels and PWV in the nonresponders and responders before and 3 months after treatment with pioglitazone. Each column and bar represents the mean ± SEM before (B) and after 3 months (A). *P < 0.05; **P < 0.01.
Tables
- Table 1—
Baseline characteristics of patients treated with or without pioglitazone
Variables Control Pioglitazone n 66 70 Sex (male/female) 32/34 32/38 Age (years) 59.3 ± 1.9 61.2 ± 1.3 BMI (kg/m2) 23.0 ± 0.5 23.4 ± 0.4 SBP (mmHg) 146 ± 2 144 ± 2 DBP (mmHg) 82 ± 2 81 ± 2 FPG (mmol/l) 9.4 ± 0.3 9.6 ± 0.4 HbA1c (%) 8.0 ± 0.2 8.1 ± 0.1 IRI (pmol/l) 55.9 ± 4.10 57.5 ± 3.96 HOMA-IR 3.30 ± 0.28 3.35 ± 0.29 Total cholesterol (mmol/l) 5.45 ± 0.16 5.46 ± 0.10 LDL cholesterol (mmol/l) 3.32 ± 0.11 3.30 ± 0.08 HDL cholesterol (mmol/l) 1.47 ± 0.10 1.44 ± 0.05 Triglycerides (mmol/l) 1.55 ± 0.04 1.56 ± 0.04 Adiponectin (μg/ml) 6.08 ± 0.42 6.03 ± 0.34 Leptin (ng/ml) 6.56 ± 0.45 6.52 ± 0.50 Treatment of diabetes (n) Diet alone 28 28 Diet + sulfonylureas 38 42 Diet + metformin 0 0 Use of antihypertensive medications (n) ACE inhibitors or angiotensin II receptor antagonists 0 0 Other 22 27 Use of lipid-lowering medications (n) Statins 19 13 Fibrates 3 1 Other 3 1 Data are means ± SEM. All group differences are nonsignificant.
- Table 2—
Results of 3-month additional treatment with pioglitazone in the study patients
Variables Control (n = 66) Pioglitazone (n = 70) Baseline 3 months Baseline 3 months BMI (kg/m2) 23.0 ± 0.5 23.2 ± 0.5 23.4 ± 0.4 23.5 ± 0.4 SBP (mmHg) 146 ± 2 146 ± 3 144 ± 2 145 ± 2 DBP (mmHg) 82 ± 2 82 ± 2 81 ± 2 81 ± 2 FPG (mmol/l) 9.4 ± 0.3 9.2 ± 0.3 9.6 ± 0.4 8.0 ± 0.3†§ HbA1c (%) 8.0 ± 0.2 7.9 ± 0.2 8.1 ± 0.1 7.1 ± 0.1†§ IRI (pmol/l) 55.9 ± 4.10 54.9 ± 4.10 57.5 ± 3.96 51.7 ± 5.18 HOMA-IR 3.30 ± 0.28 3.20 ± 0.29 3.35 ± 0.29 2.25 ± 0.17†§ Total cholesterol (mmol/l) 5.45 ± 0.16 5.46 ± 0.17 5.46 ± 0.10 5.33 ± 0.10 LDL cholesterol (mmol/l) 3.32 ± 0.11 3.33 ± 0.12 3.30 ± 0.08 3.17 ± 0.08* HDL cholesterol (mmol/l) 1.47 ± 0.10 1.43 ± 0.11 1.44 ± 0.05 1.47 ± 0.05 Triglycerides (mmol/l) 1.55 ± 0.04 1.57 ± 0.06 1.56 ± 0.04 1.50 ± 0.04 Adiponectin (μg/ml) 6.08 ± 0.42 6.06 ± 0.39 6.03 ± 0.34 7.82 ± 0.52†‡ Leptin (ng/ml) 6.56 ± 0.45 6.58 ± 0.45 6.52 ± 0.50 6.63 ± 0.46 - Table 3—
Results of 3-month additional treatment with pioglitazone in the study patients divided into two subgroups
Variables Nonresponders (n = 30) Responders (n = 40) Baseline 3 months Baseline 3 months Sex (male/female) 12/18 20/20 Age (years) 60.4 ± 2.1 61.8 ± 1.6 BMI (kg/m2) 22.7 ± 0.6 23.0 ± 0.6† 23.9 ± 0.5 23.9 ± 0.5 SBP (mmHg) 144 ± 4 143 ± 3 144 ± 3 146 ± 3 DBP (mmHg) 80 ± 2 80 ± 2 82 ± 2 83 ± 3 FPG (mmol/l) 9.4 ± 0.5 8.9 ± 0.4 9.7 ± 0.5 7.3 ± 0.4†‡ HbA1c (%) 7.8 ± 0.2 7.7 ± 0.2 8.3 ± 0.1‡ 6.8 ± 0.1†‡ IRI (pmol/l) 49.7 ± 4.96 46.8 ± 4.75 63.3 ± 5.76 55.5 ± 8.42 HOMA-IR 2.96 ± 0.38 2.62 ± 0.31* 3.65 ± 0.42 1.97 ± 0.16†‡ Total cholesterol (mmol/l) 5.40 ± 0.12 5.42 ± 0.11 5.51 ± 0.15 5.27 ± 0.16* LDL cholesterol (mmol/l) 3.32 ± 0.09 3.27 ± 0.09 3.30 ± 0.11 3.09 ± 0.12* HDL cholesterol (mmol/l) 1.37 ± 0.08 1.43 ± 0.08 1.50 ± 0.07 1.51 ± 0.07 Triglycerides (mmol/l) 1.54 ± 0.06 1.56 ± 0.05 1.57 ± 0.05 1.46 ± 0.06* Adiponectin (μg/ml) 5.98 ± 0.52 7.48 ± 0.71† 6.07 ± 0.46 8.08 ± 0.73† Leptin (ng/ml) 6.16 ± 0.79 6.21 ± 0.77 6.79 ± 0.66 6.95 ± 0.56 - Table 4—
ANCOVA models showing the differences associated with treatment with pioglitazone in CRP, PWV, and adiponectin
Variables with pioglitazone treatment Covariates Regression coefficient (SEM) P value ΔCRP Unadjusted −0.018 (0.010) 0.0262 Adjusted for ΔHbA1c −0.041 (0.013) 0.0015 ΔHOMA-IR −0.027 (0.010) 0.0117 ΔBMI −0.042 (0.010) 0.0001 ΔPWV Unadjusted −51.94 (21.61) 0.0180 Adjusted for ΔHbA1c −50.64 (27.99) 0.0423 ΔHOMA-IR −47.03 (23.31) 0.0463 ΔsBP and ΔdBP −69.49 (26.87) 0.0112 ΔLDL −54.29 (21.89) 0.0147 ΔTriglycerides −49.89 (21.75) 0.0238 ΔCRP −34.56 (23.12) 0.1381 ΔAdiponectin −29.99 (22.47) 0.1850 ΔAdiponectin Unadjusted 1.808 (0.474) 0.0002 Adjusted for ΔHbAA1c 1.522 (0.616) 0.0151 ΔHOMA-IR 0.547 (0.147) 0.0003 Changes in variables are indicated by subtracting the pretreatment value from the post-treatment value.
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