Effect of pioglitazone on various parameters of insulin resistance including lipoprotein subclass according to particle size by a gel-permeation high-performance liquid chromatography in newly diagnosed patients with type 2 diabetes

Endocrine Journal

Tetsuo Adachi³  Goji Hasegawa¹  Yoshihiro Kitagawa²  Kiyoshi Ishihara⁵  Aya Fujinami⁷  Tooru Takashima⁴  Hirokazu Hara³  Mitsuhiro Ohta⁷  Hiroshi Obayashi⁶  Koji Nakano⁵  Michiaki Fukui¹  Masakazu Ogata⁶  Masahiro Yamasaki¹  Naoto Nakamura¹ 

[1] Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan;Department of Internal Medicine, Osaka General Hospital of West Japan Railway Company, Osaka, Japan;Department of Clinical Pharmaceutics, Gifu Pharmaceutical University, Gifu, Japan;Department of Central Laboratory, Yamashiro Public Hospital, Kyoto, Japan;Department of Internal Medicine , Yamashiro Public Hospital, Kyoto, Japan;Department of Molecular Biology, Institute of Bio-Response Informatics, Kyoto, Japan;Department of Medical Biochemistry, Kobe Pharmaceutical University, Kobe, Japan

关键词: Hepatic insulin resistance;    Pioglitazone;    Lipoprotein subclass particle size;    Large VLDL;    Adiponectin;   

DOI  :  10.1507/endocrj.K10E-006

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(31)Cited-By(6)Pioglitazoneis an insulin-sensitizing agent that has been reported to haveanti-arteriosclerotic effects. The aim of this study was to obtain a betterunderstanding of the mechanism involved in the insulin sensitizing effect ofpioglitazone. A total of 50 newly diagnosed patients with type 2 diabetes wereenrolled in this study and divided into two groups, 25 of who were treated with15 mg/day pioglitazone and 25 with 500 mg/day metformin for 12 weeks. Changesin various parameters of insulin resistance including lipoprotein subclassaccording to particle size determined by high performance liquidchromatography, as well as glucose metabolism, were monitored to determine therelationship between lipoprotein subclass and other insulin resistanceparameters. Both pioglitazone and metformin treatment were associated with significantreductions in hyperglycemia, HOMA-IR and HbA1c levels. Pioglitazone treatment,but not metformin treatment resulted in significant reductions in serum largevery low-density lipoprotein (VLDL: 44.5-64.0 nm) and increases in serum adiponectinlevels (both <0.001). In the pioglitazone group, the change in large VLDLlevels correlated positively with changes in HbA1c (r=0.468, P=0.0174), HOMA-IR (r=0.593, P=0.0014), very small LDL (r=0.714, P<0.0001) and net electronegativecharged modified-LDL (r=0.412, P=0.0399), and inversely withchanges in adiponectin level (r=-0.526, P=0.0061). The results in thisstudy suggest that the hypoglycemic effect of pioglitazone is achieved mainlythrough improvement of hepatic insulin resistance, and that pioglitazone mayhave an antiatherosclerotic effect by decreasing serum atherogenic modified-LDLand by increasing adiponectin.

【 授权许可】

Unknown