Comparative Study of Low-dose Pioglitazone or Metformin Treatment in Japanese Diabetic Patients with Metabolic Syndrome

Kato, Takefumi; Sawai, Yoshikuni; Kanayama, Hitoshi; Taguchi, Hiroshi; Terabayashi, Takeshi; Taki, Fumio; Yamada, Kosuke; Yamazaki, Yuka; Hayakawa, Naohiro; Suzuki, Akiko; Oda, Naohisa; Katada, Naoyuki; Itoh, Mitsuyasu

doi:10.1055/s-0029-1202792

Cited by 15 publications

(22 citation statements)

References 35 publications

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“…Kato et al showed that significant decreases in HbA 1c and HOMA-IR after 12 weeks of low-dose PIO (15 mg/day) were associated with a significant reduction in hsCRP [30]. In this study we confirmed a strong reduction in hsCRP levels in the PIO group as compared with the PLC group.…”

Section: Discussionsupporting

confidence: 83%

Pioglitazone improves glucose metabolism and modulates skeletal muscle TIMP-3–TACE dyad in type 2 diabetes mellitus: a randomised, double-blind, placebo-controlled, mechanistic study

et al. 2013

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Section: Discussionsupporting

confidence: 83%

Pioglitazone improves glucose metabolism and modulates skeletal muscle TIMP-3–TACE dyad in type 2 diabetes mellitus: a randomised, double-blind, placebo-controlled, mechanistic study

et al. 2013

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“…In a previous study, pioglitazone improved baPWV but also decreased systolic BP 14. Therefore, it is uncertain if pioglitazone improves arterial stiffness in diabetic patients, and we considered it necessary to evaluate the effect of pioglitazone on arterial stiffness with CAVI.…”

Section: Discussionmentioning

confidence: 99%

Pioglitazone improves the cardio-ankle vascular index in patients with type 2 diabetes mellitus treated with metformin

Ohira¹,

Yamaguchi²,

Saiki³

et al. 2014

DMSO

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BackgroundType 2 diabetes is known to be associated with elevated cardiovascular mortality. Pioglitazone improves blood pressure (BP) and pulse wave velocity (PWV), which is an arterial stiffness parameter. Arterial stiffness is closely associated with cardiovascular disease. However, PWV is correlated with BP. The cardio-ankle vascular index (CAVI) reflects arterial stiffness independent of BP. Pioglitazone improves PWV but reduces blood pressure. The aim of this study was to re-evaluate the effect of pioglitazone on arterial stiffness with CAVI.MethodsSixty patients with type 2 diabetes mellitus and already on 500 mg/day of metformin received add-on therapy of pioglitazone 15 mg/day or glimepiride 1 mg/day for 6 months, during which time changes in their metabolic parameters and CAVI were observed.ResultsAfter 6 months of treatment, both pioglitazone (n=30) and glimepiride (n=30) improved fasting blood glucose and glycated hemoglobin. The changes in fasting blood glucose and glycated hemoglobin between the two groups were greater in the pioglitazone group. Systolic and diastolic BP was decreased in both groups, with no significant between-group differences. Only pioglitazone increased serum adiponectin levels, and the change in adiponectin between the pioglitazone and glimepiride groups was significantly different. CAVI was decreased significantly by pioglitazone but remained unchanged after treatment with glimepiride. The change in CAVI between the two groups was significantly different.ConclusionThese results suggest that pioglitazone improves CAVI, a BP-independent arterial stiffness parameter, in patients with type 2 diabetes mellitus treated with metformin.

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“…Mf is a widely used anti-diabetic drug. In addition to its classical effects on glucose and lipid metabolism, it inhibits low-grade inflammation and improves BMI in DM patients with MS [26,27].…”

Section: Discussionmentioning

confidence: 99%

Metabolic Syndrome and Neurotrophins: Effects of Metformin and Non-Steroidal Antiinflammatory Drug Treatment

Hristova¹

2011

EAJM

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Objective: Metabolic syndrome (MS) presents with central obesity, impaired glucose metabolism, dyslipidemia and hypertension. Our aim was to examine the effect of metformin treatment either alone or in combination with non-steroidal anti-inflammatory drugs (NSAID) on plasma levels of nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) in patients with early stage MS (MS-es) and generalized MS (MS-ge). Materials and Methods:The study compared 35 female patients with MS-es (mean age of 43.39±1.54 years) and 40 patients with MSge (mean age of 45.69±2.18 years) to 10 age-matched controls each. Patients with MS-es were administered 850 mg metformin twice daily. The patients with MS-ge were divided into two groups of 20 patients per group. One group received metformin alone, while the other group received metformin in combination with 500 mg aspirin and 150 mg Diclac daily. Plasma NGF and BDNF levels were measured by ELISA. Statistical data analysis was performed using ANOVA.Results: Plasma NGF and BDNF levels were significantly higher in MS-es patients and lower in MS-ge patients than in controls. NGF levels were decreased in both groups after treatment with metformin. NGF levels were significantly higher in MS-ge patients on combined therapy than in those on metformin only. Conclusion:The combination of metformin and NSAID treatment is more effective than metformin alone on NGF and BDNF production as well as on metabolism-related anthropometric and laboratory features. This represents a pathogenetic therapeutic mechanism in MS due to its strong anti-inflammatory effect and improves MS-ge symptoms.Key Words: Brain-derived neurotrophic factor, Early stage metabolic syndrome, Generalized metabolic syndrome, Inflammation, Nerve growth factor Özet Amaç: Metabolik sendrom (MS), santral obezite, bozulmuş glukoz metabolizması, dislipidemi ve hipertansiyon ile kendini göstermek-tedir. Hedefimiz, tek başına metformin tedavisinin ve erken evre MS'li hastalarda (MS -es) ve generalize MS (MS-ge) sinir büyüme faktörü (NGF) ve beyin kaynaklı nörotrofik faktör (BDNF) plazma düzeyleri üzerine non-steroid antienflamatuar ilaçlar (NSAID) ile birlikte etkisini araştırmaktır. Gereç ve Yöntem:Çalışma, MS-es'li 35 kadın hasta (yaş ortalaması 43.39±1.54 yıl) ve 40 MS-ge'li kadın hasta (yaş ortalaması 45.69±2.18 yıl) ve her biri ile yaş olarak eşleştirilmiş 10 hastadan oluşan kontrol grubu ile yapılmıştır. MS-es ile hastalar günde iki kez 850 mg dozda metformin verilmiştir. MS-ge ile hastalar, her biri 20 hasta iki gruba ayrıldı. Bunlar, 150 mg günlük doz 500 mg ve Diclac (Diklofenak Na) bir doz aspirin ile ya tek başına veya kombine olarak metformin almıştır. Plazma NGF ve BDNF düzeyleri ELISA yöntemi ile ölçüldü. İsta-tistik veri işleme, ANOVA yöntemi ile yapıldı. Bulgular: Plazma NGF ve BDNF MS-es hastalarda önemli ölçüde daha yüksek ve MS-ge olanlar kontrollere göre daha düşüktü. NGF düzeyleri metformin ile tedavi sonrasında her iki grupta da azalmıştır. NGF seviyeleri sadece bu on metformin kombine tedavi MS-...

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Comparative Study of Low-dose Pioglitazone or Metformin Treatment in Japanese Diabetic Patients with Metabolic Syndrome

Cited by 15 publications

References 35 publications

Pioglitazone improves glucose metabolism and modulates skeletal muscle TIMP-3–TACE dyad in type 2 diabetes mellitus: a randomised, double-blind, placebo-controlled, mechanistic study

Pioglitazone improves glucose metabolism and modulates skeletal muscle TIMP-3–TACE dyad in type 2 diabetes mellitus: a randomised, double-blind, placebo-controlled, mechanistic study

Pioglitazone improves the cardio-ankle vascular index in patients with type 2 diabetes mellitus treated with metformin

Metabolic Syndrome and Neurotrophins: Effects of Metformin and Non-Steroidal Antiinflammatory Drug Treatment

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