Pioglitazone use and risk of bladder cancer in diabetic patient is one of the major causes of morbidity and mortality. Increasing evidence from the clinical studies suggested increased risk of bladder cancer with higher dose and longer duration of pioglitazone use. In contrast, few studies reported non-significant association with pioglitazone use and risk of bladder cancer in T2DM patients. Therefore, we aimed to review and summarize the available clinical data describing the risk of bladder cancer associated with pioglitazone treatment.

Objective: Periostin may be playing a central role in the pathogenesis of heart failure and myocardial infraction among patients with diabetes, and therapies targeting the periostin pathway may represent a novel treatment strategy. The unmet need of early detection and diagnosis of cardiovascular (CV) risk in patients with type 2 diabetes mellitus (T2DM) is required to ensure adequate prevention to delay the diabetic complications. Therefore, the aim of this study is to find out the association between periostin level, anthropometric measurements, and inflammatory biomarkers in patients with T2DM. Design and method: A cross-sectional study included a total of 130 Indian T2DM patients and 40 healthy control. All anthropometric measures and biochemical parameters including periostin, high sensitivity C-reactive protein (hsCRP), and leukocyte count were estimated. Pearson's correlation analysis was performed to assess the significant association between periostin level and other biochemical parameters. p-values <0.05 were considered statistically significant. Results: The mean age of the included participants were 52.42 years. Serum periostin levels were higher among obese T2DM patients. Correlation analysis showed positive correlation between serum periostin levels and waist circumference (WC), BMI, waist-hip ratio (WHR), fasting plasma glucose (FPG), postprandial glucose (PPG), glycated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC), hsCRP, leukocyte count (p < 0.05) however, negative correlation was observed with high-density lipoprotein cholesterol (HDL-C) (p < 0.05). After adjustment, regression model showed hsCRP, BMI, TG were independent predictors of elevated serum periostin (p < 0.05). Conclusions: Evidence from the current study suggested that periostin levels were higher among patients with higher BMI groups and it is significantly associated with lipid profile, anthropometric measures, and inflammatory biomarkers. periostin may consider as a novel biomarker to measure the early cardiovascular risk. However, lacking follow-up it further creates room for future investigation. Therefore, further real-world studies warrant to robust the present findings.