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Differential effect of pioglitazone (PGZ) and rosiglitazone (RGZ) on postprandial glucose and lipid metabolism in patients with type 2 diabetes mellitus: a prospective, randomized crossover study.
Diabetes Metab Res Rev. 2007 Jul; 23(5):392-9.DM

Abstract

BACKGROUND

Postprandial metabolism is impaired in patients with type 2 diabetes (T2Dm). Two thiazolidinediones pioglitazone (PGZ) and rosiglitazone (RGZ) have similar effects on glycaemic control but differ in their effects on fasting lipids. This study investigated the effects of RGZ and PGZ on postprandial metabolism in a prospective, randomized crossover trial.

METHODS

Seventeen patients with T2Dm were randomized to RGZ or PGZ for 12 weeks, with an 8-week wash-out period. Fasting blood samples were taken for glucose (FPG), insulin, HbA(1c), lipids, apolipoproteins (apo), lipoprotein (LPL) and hepatic lipase (HL), and cholesterol ester transfer protein (CETP) activity. A standardized breakfast was served and postprandial glucose, insulin, and lipid subfraction profiles were determined.

RESULTS

RGZ and PGZ treatment resulted in a similar improvement in FPG, HbA(1c) and homeostasis model assessment. Fasting and postprandial triglyceride (TG) levels were significantly lower following PGZ therapy (fasting: -0.35 vs 0.44 mmol/L; p < 0.04; postprandial AUC-TG: -195.6 vs 127.9 mmol/L/min; p < 0.02) associated with changes in VLDL-2-TG (-0.10 vs 0.21 mmol/L; p = 0.23) and VLDL-3-TG (0.0 vs 0.34 mmol/L; p < 0.04). Fasting cholesterol increased with RGZ compared to PGZ (0.06 vs 0.59 mmol/L; p < 0.04), particularly in VLDL-2-C (-0.30 vs 0.59 mmol/L; p < 0.03) and VLDL-3-C (-0.85 vs 2.11 mmol/L; p < 0.02). Postprandial VLDL lipid and protein content increased after RGZ and decreased after PGZ. Fasting apoB, apoA-I, apoC-II/C-III-ratio, and LPL activity did not differ. CETP activity decreased after RGZ and increased after PGZ (-6.2 vs 4.2 p/mol/mL/min; p < 0.002).

CONCLUSIONS

Both the glitazones had similar effects on glucose metabolism. The additional beneficial effect of PGZ on lipid metabolism may be related to its effects on insulin-independent VLDL production and CETP activity.

Authors+Show Affiliations

Division of Endocrinology, Diabetes and Clinical Nutrition, University Hospital of Berne, Inselspital, CH-3010 Bern, Switzerland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17211855

Citation

Chappuis, Bernard, et al. "Differential Effect of Pioglitazone (PGZ) and Rosiglitazone (RGZ) On Postprandial Glucose and Lipid Metabolism in Patients With Type 2 Diabetes Mellitus: a Prospective, Randomized Crossover Study." Diabetes/metabolism Research and Reviews, vol. 23, no. 5, 2007, pp. 392-9.
Chappuis B, Braun M, Stettler C, et al. Differential effect of pioglitazone (PGZ) and rosiglitazone (RGZ) on postprandial glucose and lipid metabolism in patients with type 2 diabetes mellitus: a prospective, randomized crossover study. Diabetes Metab Res Rev. 2007;23(5):392-9.
Chappuis, B., Braun, M., Stettler, C., Allemann, S., Diem, P., Lumb, P. J., Wierzbicki, A. S., James, R., & Christ, E. R. (2007). Differential effect of pioglitazone (PGZ) and rosiglitazone (RGZ) on postprandial glucose and lipid metabolism in patients with type 2 diabetes mellitus: a prospective, randomized crossover study. Diabetes/metabolism Research and Reviews, 23(5), 392-9.
Chappuis B, et al. Differential Effect of Pioglitazone (PGZ) and Rosiglitazone (RGZ) On Postprandial Glucose and Lipid Metabolism in Patients With Type 2 Diabetes Mellitus: a Prospective, Randomized Crossover Study. Diabetes Metab Res Rev. 2007;23(5):392-9. PubMed PMID: 17211855.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differential effect of pioglitazone (PGZ) and rosiglitazone (RGZ) on postprandial glucose and lipid metabolism in patients with type 2 diabetes mellitus: a prospective, randomized crossover study. AU - Chappuis,Bernard, AU - Braun,Monika, AU - Stettler,Christoph, AU - Allemann,Sabine, AU - Diem,Peter, AU - Lumb,Peter J, AU - Wierzbicki,Anthony S, AU - James,Richard, AU - Christ,Emanuel R, PY - 2007/1/11/pubmed PY - 2007/9/27/medline PY - 2007/1/11/entrez SP - 392 EP - 9 JF - Diabetes/metabolism research and reviews JO - Diabetes Metab Res Rev VL - 23 IS - 5 N2 - BACKGROUND: Postprandial metabolism is impaired in patients with type 2 diabetes (T2Dm). Two thiazolidinediones pioglitazone (PGZ) and rosiglitazone (RGZ) have similar effects on glycaemic control but differ in their effects on fasting lipids. This study investigated the effects of RGZ and PGZ on postprandial metabolism in a prospective, randomized crossover trial. METHODS: Seventeen patients with T2Dm were randomized to RGZ or PGZ for 12 weeks, with an 8-week wash-out period. Fasting blood samples were taken for glucose (FPG), insulin, HbA(1c), lipids, apolipoproteins (apo), lipoprotein (LPL) and hepatic lipase (HL), and cholesterol ester transfer protein (CETP) activity. A standardized breakfast was served and postprandial glucose, insulin, and lipid subfraction profiles were determined. RESULTS: RGZ and PGZ treatment resulted in a similar improvement in FPG, HbA(1c) and homeostasis model assessment. Fasting and postprandial triglyceride (TG) levels were significantly lower following PGZ therapy (fasting: -0.35 vs 0.44 mmol/L; p < 0.04; postprandial AUC-TG: -195.6 vs 127.9 mmol/L/min; p < 0.02) associated with changes in VLDL-2-TG (-0.10 vs 0.21 mmol/L; p = 0.23) and VLDL-3-TG (0.0 vs 0.34 mmol/L; p < 0.04). Fasting cholesterol increased with RGZ compared to PGZ (0.06 vs 0.59 mmol/L; p < 0.04), particularly in VLDL-2-C (-0.30 vs 0.59 mmol/L; p < 0.03) and VLDL-3-C (-0.85 vs 2.11 mmol/L; p < 0.02). Postprandial VLDL lipid and protein content increased after RGZ and decreased after PGZ. Fasting apoB, apoA-I, apoC-II/C-III-ratio, and LPL activity did not differ. CETP activity decreased after RGZ and increased after PGZ (-6.2 vs 4.2 p/mol/mL/min; p < 0.002). CONCLUSIONS: Both the glitazones had similar effects on glucose metabolism. The additional beneficial effect of PGZ on lipid metabolism may be related to its effects on insulin-independent VLDL production and CETP activity. SN - 1520-7552 UR - https://www.unboundmedicine.com/medline/citation/17211855/Differential_effect_of_pioglitazone__PGZ__and_rosiglitazone__RGZ__on_postprandial_glucose_and_lipid_metabolism_in_patients_with_type_2_diabetes_mellitus:_a_prospective_randomized_crossover_study_ L2 - https://doi.org/10.1002/dmrr.715 DB - PRIME DP - Unbound Medicine ER -