Pioglitazone slows progression of atherosclerosis in prediabetes independent of changes in cardiovascular risk factors.
Citation: Arteriosclerosis, Thrombosis & Vascular Biology. 33(2):393-9, 2013 Feb.PMID: 23175674Institution: MedStar Health Research InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | Multicenter Study | Randomized Controlled Trial | Research Support, Non-U.S. Gov't | Research Support, U.S. Gov't, Non-P.H.S.Subject headings: *Carotid Artery Diseases/pc [Prevention & Control] | *Diabetes Mellitus, Type 2/pc [Prevention & Control] | *Hypoglycemic Agents/tu [Therapeutic Use] | *Prediabetic State/dt [Drug Therapy] | *Thiazolidinediones/tu [Therapeutic Use] | Adiponectin/bl [Blood] | Adult | Aged | Biological Markers/bl [Blood] | Blood Glucose/de [Drug Effects] | Blood Glucose/me [Metabolism] | Carotid Artery Diseases/bl [Blood] | Carotid Artery Diseases/di [Diagnosis] | Carotid Artery Diseases/et [Etiology] | Carotid Intima-Media Thickness | Chi-Square Distribution | Cholesterol, HDL/bl [Blood] | Diabetes Mellitus, Type 2/bl [Blood] | Diabetes Mellitus, Type 2/di [Diagnosis] | Diabetes Mellitus, Type 2/et [Etiology] | Disease Progression | Double-Blind Method | Female | Hemoglobin A, Glycosylated/me [Metabolism] | Humans | Insulin/bl [Blood] | Linear Models | Male | Middle Aged | Multivariate Analysis | Plasminogen Activator Inhibitor 1/bl [Blood] | Prediabetic State/bl [Blood] | Prediabetic State/co [Complications] | Prediabetic State/di [Diagnosis] | Prospective Studies | Risk Assessment | Risk Factors | Time Factors | Treatment Outcome | United StatesYear: 2013Local holdings: Available online from MWHC library: 1995 - presentISSN:- 1079-5642
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 23175674 | Available | 23175674 |
Available online from MWHC library: 1995 - present
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.
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