Pioglitazone slows progression of atherosclerosis  in prediabetes independent of changes in cardiovascular risk  factors. 

 -  2013 
<br/><br/>Available online from MWHC library: 1995 - present 
<br/><br/> CONCLUSIONS: Pioglitazone slowed progression of  CIMT, independent of improvement in hyperglycemia, insulin  resistance, dyslipidemia, and systemic inflammation in  prediabetes. These results suggest a possible direct  vascular benefit of pioglitazone.  METHODS AND RESULTS: CIMT was measured in 382  participants at the beginning and up to 3 additional times  during follow-up of the Actos Now for Prevention of Diabetes  trial. During an average follow-up of 2.3 years, the mean  unadjusted annual rate of CIMT progression was significantly  (P=0.01) lower with pioglitazone treatment (4.76x10(-3)  mm/year; 95% CI: 2.39x10(-3)-7.14x10(-3) mm/year) compared  with placebo (9.69x10(-3) mm/year; 95% CI:  7.24x10(-3)-12.15x10(-3) mm/year). High-density lipoprotein  cholesterol, fasting and 2-hour glucose, HbA(1c), fasting  insulin, Matsuda insulin sensitivity index, adiponectin, and  plasminogen activator inhibitor-1 levels improved  significantly with pioglitazone treatment compared with  placebo (P<0.001). However, the effect of pioglitazone on  CIMT progression was not attenuated by multiple methods of  adjustment for traditional, metabolic, and inflammatory risk  factors and concomitant medications, and was independent of  changes in risk factors during pioglitazone treatment.  OBJECTIVE: To determine whether changes in  standard and novel risk factors during the Actos Now for  Prevention of Diabetes trial explained the slower rate of  carotid intima media thickness (CIMT) progression with  pioglitazone treatment in persons with prediabetes. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>1079-5642 
<br/><br/><label>Subjects--Topical Terms: </label><br/>*Carotid Artery Diseases/pc [Prevention & Control]<br/>*Diabetes Mellitus, Type 2/pc [Prevention &  Control]<br/>*Hypoglycemic Agents/tu [Therapeutic Use]<br/>*Prediabetic State/dt [Drug Therapy]<br/>*Thiazolidinediones/tu [Therapeutic Use]<br/>Adiponectin/bl [Blood]<br/>Adult<br/>Aged<br/>Biological Markers/bl [Blood]<br/>Blood Glucose/de [Drug Effects]<br/>Blood Glucose/me [Metabolism]<br/>Carotid Artery Diseases/bl [Blood]<br/>Carotid Artery Diseases/di [Diagnosis]<br/>Carotid Artery Diseases/et [Etiology]<br/>Carotid Intima-Media Thickness<br/>Chi-Square Distribution<br/>Cholesterol, HDL/bl [Blood]<br/>Diabetes Mellitus, Type 2/bl [Blood]<br/>Diabetes Mellitus, Type 2/di [Diagnosis]<br/>Diabetes Mellitus, Type 2/et [Etiology]<br/>Disease Progression<br/>Double-Blind Method<br/>Female<br/>Hemoglobin A, Glycosylated/me [Metabolism]<br/>Humans<br/>Insulin/bl [Blood]<br/>Linear Models<br/>Male<br/>Middle Aged<br/>Multivariate Analysis<br/>Plasminogen Activator Inhibitor 1/bl [Blood]<br/>Prediabetic State/bl [Blood]<br/>Prediabetic State/co [Complications]<br/>Prediabetic State/di [Diagnosis]<br/>Prospective Studies<br/>Risk Assessment<br/>Risk Factors<br/>Time Factors<br/>Treatment Outcome<br/>United States
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar Health Research Institute
<br/><br/><label>Index Terms--Function: </label><br/>Journal Article<br/>Multicenter Study<br/>Randomized Controlled Trial<br/>Research Support, Non-U.S. Gov't<br/>Research Support, U.S. Gov't, Non-P.H.S.