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Pharmacodynamic Effects of Low-Dose Pioglitazone in Patients with the Metabolic Syndrome without Diabetes Mellitus.

Abstract：

STUDY OBJECTIVE:To determine the effects of low-dose pioglitazone on plasma adipocyte-derived cytokines, high-sensitivity C-reactive protein (hs-CRP), and components of the metabolic syndrome in adults with the metabolic syndrome without diabetes mellitus. DESIGN:Prospective, randomized, double-blind, placebo-controlled study. SETTING:University of Colorado Clinical and Translational Research Center. PATIENTS:Thirty-two men and women, aged 30-60 years, without diabetes who had a clinical diagnosis of the metabolic syndrome, as defined by the American Heart Association/National Heart, Lung, and Blood Institute criteria. INTERVENTION:Patients were randomly assigned to receive oral pioglitazone 7.5 mg daily or matching placebo for 8 weeks. MEASUREMENTS AND MAIN RESULTS:The primary end point was the change in plasma high-molecular-weight (HMW) adiponectin level from baseline to week 8. Other end points were changes in plasma total adiponectin, omentin, and hs-CRP levels, and changes in components of the metabolic syndrome (e.g., insulin sensitivity) from baseline to week 8. Pioglitazone was associated with a significant increase in plasma HMW adiponectin from baseline to week 8 compared with placebo (+47% vs -10%, p<0.001). Insulin sensitivity increased significantly from baseline to week 8 in the pioglitazone group (+88%, p=0.02) but not in the placebo group (+15%, p=0.14). Change in HMW adiponectin was significantly correlated with the change in insulin sensitivity in the pioglitazone group (r = 0.784, p=0.003). No significant differences in mean percentage changes in plasma total adiponectin, omentin, and hs-CRP levels were observed between the pioglitazone and placebo groups. Likewise, changes in body weight, insulin sensitivity, glucose, lipids, and blood pressure did not differ significantly between the groups. CONCLUSION:Low-dose pioglitazone favorably modulates plasma HMW adiponectin, which was associated with an improvement in insulin sensitivity, in patients with the metabolic syndrome without diabetes.

journal_name

Pharmacotherapy

journal_title

Pharmacotherapy

authors

Vu A,Kosmiski LA,Beitelshees AL,Prigeon R,Sidhom MS,Bredbeck B,Predhomme J,Deininger KM,Aquilante CL

doi

10.1002/phar.1713

subject

Has Abstract

pub_date

2016-03-01 00:00:00

pages

252-62

issue

eissn

0277-0008

issn

1875-9114

journal_volume

pub_type

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Pharmacodynamic Effects of Low-Dose Pioglitazone in Patients with the Metabolic Syndrome without Diabetes Mellitus.