TY  - BOOK
AU  - Ratner, Robert E
TI  - Baseline adiponectin levels do not influence the response to pioglitazone in ACT NOW
SN  - 0149-5992
PY  - 2014///
KW  - *Adiponectin/bl [Blood]
KW  - *Diabetes Mellitus, Type 2/bl [Blood]
KW  - *Diabetes Mellitus, Type 2/dt [Drug Therapy]
KW  - *Glucose Intolerance/dt [Drug Therapy]
KW  - *Hypoglycemic Agents/tu [Therapeutic Use]
KW  - *Insulin Resistance
KW  - *Thiazolidinediones/tu [Therapeutic Use]
KW  - Blood Glucose/an [Analysis]
KW  - Cohort Studies
KW  - Disease Progression
KW  - Female
KW  - Follow-Up Studies
KW  - Glucose Intolerance/bl [Blood]
KW  - Glucose Tolerance Test
KW  - Humans
KW  - Insulin-Secreting Cells/me [Metabolism]
KW  - Insulin/tu [Therapeutic Use]
KW  - Male
KW  - Middle Aged
KW  - MedStar Health Research Institute
KW  - Journal Article
KW  - Randomized Controlled Trial
KW  - Research Support, N.I.H., Extramural
KW  - Research Support, Non-U.S. Gov't
KW  - Research Support, U.S. Gov't, Non-P.H.S
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - CONCLUSIONS: Baseline adiponectin does not predict the response to pioglitazone. The increase in plasma adiponectin concentration after pioglitazone therapy in IGT subjects is strongly related to improved glucose tolerance status and enhanced tissue sensitivity to insulin.Copyright � 2014 by the American Diabetes Association; OBJECTIVE: Plasma adiponectin levels are reduced in type 2 diabetes mellitus (T2DM) and other insulin-resistant states. We examined whether plasma adiponectin levels at baseline and after pioglitazone treatment in impaired glucose tolerance (IGT) subjects were associated with improved insulin sensitivity (SI) and glucose tolerance status; RESEARCH DESIGN AND METHODS: A total of 602 high-risk IGT subjects in ACT NOW were randomized to receive pioglitazone or placebo with a median follow-up of 2.4 years; RESULTS: Pioglitazone reduced IGT conversion to diabetes by 72% in association with improved beta-cell function by 64% (insulin secretion/insulin resistance index) and increased tissue sensitivity by 88% (Matsuda index). In pioglitazone-treated subjects, plasma adiponectin concentration increased threefold from 13 +/- 0.5 to 38 +/- 2.5 mug/mL (P < 0.001) and was strongly correlated with the improvement in SI (r = 0.436, P < 0.001) and modestly correlated with glucose area under the curve during oral glucose tolerance test (r = 0.238, P < 0.005) and insulin secretion/insulin resistance index (r = 0.306, P < 0.005). The increase in adiponectin was a strong predictor of reversion to normal glucose tolerance and prevention of T2DM. In the placebo group, plasma adiponectin did not change and was not correlated with changes in glucose levels. There was an inverse association between baseline plasma adiponectin concentration and progression to diabetes in the placebo group but not in the pioglitazone group
UR  - http://dx.doi.org/10.2337/dc13-1745
ER  -