Pioglitazone improves endothelial and adipose tissue dysfunction in pre-diabetic CAD subjects

• Published in: Atherosclerosis Vol. 215; no. 1; pp. 180 - 183
• Main Authors: Rizza, Stefano, Cardellini, Marina, Porzio, Ottavia, Pecchioli, Chiara, Savo, Alessia, Cardolini, Iris, Senese, Nicoletta, Lauro, Davide, Sbraccia, Paolo, Lauro, Renato, Federici, Massimo
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01.03.2011; Elsevier
• Subjects: adiponectin; Adiponectin - metabolism; Adipose tissue; Adipose Tissue - drug effects; Adipose Tissue - physiopathology; Associated diseases and complications; atherosclerosis; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular; Diabetes; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Endothelium, Vascular - drug effects; Endothelium, Vascular - physiopathology; Female; foot-and-mouth disease; glucose; glucose clamp technique; Humans; Hypoglycemic Agents - therapeutic use; Inflammation; Insulin resistance; Male; Medical sciences; Middle Aged; molecular weight; patients; Prediabetic State - drug therapy; regression analysis; Thiazolidinediones - therapeutic use; tumor necrosis factor-alpha; Insulin resistance; Inflammation; Adipose tissue; Diabetes; Endocrinopathy; Human; Agonist; Diabetes mellitus; Pioglitazone; Metabolic diseases; Cardiovascular disease; Thiazolidinedione derivatives; PPAR-γ receptor; Vascular disease; Target tissue resistance; Hypoglycemic agent; Atherosclerosis; Endothelial dysfunction
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2010.12.021

Abstract Objective To investigate the effect of pioglitazone on endothelial and adipose tissue dysfunction in newly detected IGT patients with CAD. Methods and design Participants ( n = 25) were randomized to treatment with either placebo or pioglitazone (30 mg/day) for 12 weeks. Before and after treatment we evaluated endothelial function (flow-mediated dilation – FMD – of the brachial artery), circulating adipose and inflammatory markers (adiponectin isoforms, TNF-alpha, and high sensitivity-CRP), and insulin sensitivity (euglycemic hyperinsulinemic clamp). Results No significant changes were observed in subjects ( n = 12) treated with placebo. By contrast, subjects ( n = 13) treated with pioglitazone had significant improvement in FMD (10.8 ± 5.3 vs 13.3 ± 3.6%, p < 0.01), accompanied by increased high molecular weight adiponectin (HMW-Ad) (1.7 ± 1.2 vs 4.8 ± 3.6 μg/ml, p < 0.05) and decreased TNF-alpha (4.3 ± 1.9 vs 3.2 ± 1.2 pg/ml, p < 0.05) associated to an increased glucose disposal (4.8 ± 1.9 vs 5.4 ± 2.0 mg kg−1 min−1 , p < 0.05). A multiple regression analysis indicated that increasing of HMW-Ad after pioglitazone predicted increased FMD. Conclusion Pioglitazone significantly improves endothelial and adipose tissue dysfunction in pre-diabetic patients with CAD.