J Korean Diabetes Assoc.  2006 Jul;30(4):264-276. 10.4093/jkda.2006.30.4.264.

Long-term Effect of Pioglitazone Treatment in Patients with Type 2 Diabetes

• Moon JH
• Kim HJ
• Kim SK
• Shim WS
• Kang ES
• Rhee Y
• Ahn CW
• Lim SK
• Kim KR
• Lee HC
• Cha BS

• KMID: 2177598
• DOI: http://doi.org/10.4093/jkda.2006.30.4.264

Abstract

BACKGROUND: Type 2 diabetes is characterized by impaired insulin secretion and/or insulin resistance. Thiazolidinediones have been shown to ameliorate insulin resistance. The purpose of the present study was to evaluate the long term serial effect of pioglitazone on anthropometrics and metabolic parameters in Korean type 2 diabetes patients.
METHODS
One hundred thirteen type 2 diabetes patients (male, 67; female, 46; mean age, 49.1+/-10.8 years) were evaluated before and after 3 months, 6 months and 12 months of treatment with pioglitazone (Actos(TM), 15 mg/day). Anthropometric parameters and metabolic variables were measured.
RESULTS
Body weight and body mass index (BMI) were increased in 3 months after pioglitazone treatment (body weight, 68.8+/-12.2 vs 69.8+/-11.9 kg, P < 0.01) without further increase. In women, body weight and BMI tended to increase more (body weight change after 3 months, 0.6+/-1.7 kg vs 1.6+/-1.7 kg, P < 0.01) and longer (3 months vs 6 months) than in men. Fasting plasma glucose (FPG) and HbA1c were decreased in 3 months after pioglitazone treatment (FPG, 7.97+/-2.29 vs 6.94+/-2.01 mmol/L, P < 0.01; HbA1c, 7.7+/-1.5 vs 7.0+/-1.1%, P < 0.01). Hypoglycemic effect of pioglitazone was prominent in women than in men (FPG change after 12 months, -1.80+/-2.54 vs -0.09+/-1.72 mmol/L, P < 0.001; HbA1c change after 12 months, -0.9+/-1.3 vs -0.4+/-1.1%, P < 0.05). Serum high-density lipoprotein cholesterol was increased after 3 months of pioglitazone treatment (1.16+/-0.24 vs 1.31+/-0.28 mmol/L, P < 0.01) without return until the end of this study. Serum triglycerides level decreased at 3 months (basal vs 3 months, 2.29+/-1.86 vs 1.88+/-1.21 mmol/L, P < 0.01) and 6 months (basal vs 6 months, 2.29+/-1.86 vs 1.97+/-1.40 mmol/L, P < 0.05) of pioglitazone treatment, but returned to basal level at 12 months. Liver enzyme, especially serum alanine transferase level decreased after 3 months of pioglitazone treatment (30.8+/-23.7 vs 24.5+/-18.5 IU/L, P < 0.01) without return until the end of this study. Hypoglycemic effect of pioglitazone was associated with basal BMI, fat contents and serum leptin level.
CONCLUSION
Korean type 2 diabetes patients with pioglitazone use showed favorable metabolic effect for glycemic control, lipid metabolism and liverfunction, but pioglitazone induced body weight increase may be limited.

Keyword

Anthropometrics; Pioglitazone; Thiazolidinedione

MeSH Terms

Alanine
Blood Glucose
Body Mass Index
Body Weight
Cholesterol
Fasting
Female
Humans
Hypoglycemic Agents
Insulin
Insulin Resistance
Leptin
Lipid Metabolism
Lipoproteins
Liver
Male
Thiazolidinediones
Transferases
Triglycerides
Alanine
Cholesterol
Hypoglycemic Agents
Insulin
Leptin
Lipoproteins
Thiazolidinediones
Transferases
Triglycerides

Figure

• 

  Fig. 1 Changes of body weight and BMI after pioglitazone treatment. A. Total study patients (n = 113). B. Male (n = 67) and female (n = 46) study patients. BMI, body mass index. *p < 0.01.

• 

  Fig. 2 Hypoglycemic effects after pioglitazone treatment. A. Total study patients (n = 113). B. Male (n = 67) and female (n = 46) study patients. FPG, fasting plasma glucose; HbAlc, glycosylated hemoglobin. *p < 0.01.

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  Fig. 3 Changes in lipid profiles after pioglitazone treatment (n = 113). HDL, high density lipoprotein. *p < 0.01 versus baseline. †p < versus baseline.

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  Fig. 4 Changes in liver enzymes after pioglitazone treatment (n = 113). AST, aspertate transaminase; ALT, alanine transminase. *p < 0.01.

• 

  Fig. 5 Correaltions between △FPG and basal parameters. △FPG, 12 months fasting plasma glucose-baseline fasting plasma glucose; BMI, body mass index.

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  Fig. 6 Changes of body weight and BMI after pioglitazone treatment in each oral hypoglycemic agent use. SU, sulfonylurea use (n = 21); Met, metformin use (n = 53); SU+Met, sulfonylurea + metformin use (n = 39); BMI, body mass index. *p < 0.01.

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