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Effects of pioglitazone and metformin on plasma adiponectin in newly detected type 2 diabetes mellitus.
Clin Endocrinol (Oxf). 2006 Dec; 65(6):722-8.CE

Abstract

OBJECTIVE

This prospective study evaluates the effect of insulin sensitizers, pioglitazone (PGZ) and metformin (MET) on plasma adiponectin and leptin levels in subjects newly diagnosed with type 2 diabetes mellitus (T2DM).

DESIGN

Double blind, randomized, active control, dose escalation study of 12 weeks treatment duration.

PATIENTS

Thirty apparently healthy, treatment-naive T2DM patients diagnosed within the past 6 months.

MEASUREMENTS

Plasma adiponectin and leptin levels were estimated by enzyme-linked immunosorbent assay (ELISA), and insulin resistance by the homeostasis model of assessment (HOMA-IR).

RESULTS

Baseline plasma levels of adiponectin were lower in diabetic (n = 30) subjects than matched controls (n = 10, 6.6 +/- 1.1 vs 10.4 +/- 4.2 microg/ml, P = 0.021). The 12-week treatment with PGZ significantly increased adiponectin concentrations (6.6 +/- 1.1-17.9 +/- 7.4 microg/ml, P < 0.001) with no alteration in the MET treated group (6.8 +/- 1.5-6.7 +/- 2.8 microg/ml, P = 0.9). A significant decrease in plasma leptin levels was observed in the MET treated group (32.0 +/- 28.9-21.4 +/- 23.3 ng/ml, P = 0.024) but not in the PGZ treated group (23.9 +/- 24.1-22.4 +/- 25.4 ng/ml, P = 0.69). The alterations in plasma adiponectin and leptin levels were not associated with any change in body mass index (BMI). PGZ therapy improved insulin sensitivity to a greater degree (P = 0.007 and P = 0.001 for fasting plasma insulin (FPI) and HOMA-IR, respectively) than MET (P = 0.75 and P = 0.02 for FPI and HOMA-IR, respectively) but this improvement was not significantly different from that of MET at the end of 12 weeks (P = 0.146 and P = 0.09 for FPI and HOMA-IR, respectively). However, improvement in insulin sensitivity with PGZ was not commensurate with the increase in adiponectin. Better control of postbreakfast plasma glucose (PBPG) as well as decrease in serum triglycerides (TGs) were also seen with PGZ (PBPG, P < 0.001; TGs, P = 0.013). The rest of the parameters were comparable. Adverse reactions reported were minor and did not result in treatment discontinuation.

CONCLUSIONS

Pioglitazone therapy appears to be better in achieving glycaemic control and increasing plasma adiponectin and insulin sensitivity in newly detected type 2 diabetics.

Authors+Show Affiliations

Department of Pharmacology, PGIMER, Chandigarh, India.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

17121522

Citation

Sharma, Pramod Kumar, et al. "Effects of Pioglitazone and Metformin On Plasma Adiponectin in Newly Detected Type 2 Diabetes Mellitus." Clinical Endocrinology, vol. 65, no. 6, 2006, pp. 722-8.
Sharma PK, Bhansali A, Sialy R, et al. Effects of pioglitazone and metformin on plasma adiponectin in newly detected type 2 diabetes mellitus. Clin Endocrinol (Oxf). 2006;65(6):722-8.
Sharma, P. K., Bhansali, A., Sialy, R., Malhotra, S., & Pandhi, P. (2006). Effects of pioglitazone and metformin on plasma adiponectin in newly detected type 2 diabetes mellitus. Clinical Endocrinology, 65(6), 722-8.
Sharma PK, et al. Effects of Pioglitazone and Metformin On Plasma Adiponectin in Newly Detected Type 2 Diabetes Mellitus. Clin Endocrinol (Oxf). 2006;65(6):722-8. PubMed PMID: 17121522.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of pioglitazone and metformin on plasma adiponectin in newly detected type 2 diabetes mellitus. AU - Sharma,Pramod Kumar, AU - Bhansali,Anil, AU - Sialy,Ravinder, AU - Malhotra,Samir, AU - Pandhi,Promila, PY - 2006/11/24/pubmed PY - 2007/6/26/medline PY - 2006/11/24/entrez SP - 722 EP - 8 JF - Clinical endocrinology JO - Clin Endocrinol (Oxf) VL - 65 IS - 6 N2 - OBJECTIVE: This prospective study evaluates the effect of insulin sensitizers, pioglitazone (PGZ) and metformin (MET) on plasma adiponectin and leptin levels in subjects newly diagnosed with type 2 diabetes mellitus (T2DM). DESIGN: Double blind, randomized, active control, dose escalation study of 12 weeks treatment duration. PATIENTS: Thirty apparently healthy, treatment-naive T2DM patients diagnosed within the past 6 months. MEASUREMENTS: Plasma adiponectin and leptin levels were estimated by enzyme-linked immunosorbent assay (ELISA), and insulin resistance by the homeostasis model of assessment (HOMA-IR). RESULTS: Baseline plasma levels of adiponectin were lower in diabetic (n = 30) subjects than matched controls (n = 10, 6.6 +/- 1.1 vs 10.4 +/- 4.2 microg/ml, P = 0.021). The 12-week treatment with PGZ significantly increased adiponectin concentrations (6.6 +/- 1.1-17.9 +/- 7.4 microg/ml, P < 0.001) with no alteration in the MET treated group (6.8 +/- 1.5-6.7 +/- 2.8 microg/ml, P = 0.9). A significant decrease in plasma leptin levels was observed in the MET treated group (32.0 +/- 28.9-21.4 +/- 23.3 ng/ml, P = 0.024) but not in the PGZ treated group (23.9 +/- 24.1-22.4 +/- 25.4 ng/ml, P = 0.69). The alterations in plasma adiponectin and leptin levels were not associated with any change in body mass index (BMI). PGZ therapy improved insulin sensitivity to a greater degree (P = 0.007 and P = 0.001 for fasting plasma insulin (FPI) and HOMA-IR, respectively) than MET (P = 0.75 and P = 0.02 for FPI and HOMA-IR, respectively) but this improvement was not significantly different from that of MET at the end of 12 weeks (P = 0.146 and P = 0.09 for FPI and HOMA-IR, respectively). However, improvement in insulin sensitivity with PGZ was not commensurate with the increase in adiponectin. Better control of postbreakfast plasma glucose (PBPG) as well as decrease in serum triglycerides (TGs) were also seen with PGZ (PBPG, P < 0.001; TGs, P = 0.013). The rest of the parameters were comparable. Adverse reactions reported were minor and did not result in treatment discontinuation. CONCLUSIONS: Pioglitazone therapy appears to be better in achieving glycaemic control and increasing plasma adiponectin and insulin sensitivity in newly detected type 2 diabetics. SN - 0300-0664 UR - https://www.unboundmedicine.com/medline/citation/17121522/Effects_of_pioglitazone_and_metformin_on_plasma_adiponectin_in_newly_detected_type_2_diabetes_mellitus_ L2 - https://doi.org/10.1111/j.1365-2265.2006.02658.x DB - PRIME DP - Unbound Medicine ER -