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Pioglitazone induces regression and stabilization of coronary atherosclerotic plaques in patients with impaired glucose tolerance
Author(s) -
Yang H.B.,
Zhao X.Y.,
Zhang J.Y.,
Du Y.Y.,
Wang X.F.
Publication year - 2012
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2011.03458.x
Subject(s) - medicine , pioglitazone , adiponectin , ejection fraction , cardiology , endothelin receptor , placebo , coronary atherosclerosis , endocrinology , c reactive protein , diabetes mellitus , gastroenterology , type 2 diabetes , inflammation , heart failure , insulin resistance , coronary heart disease , insulin , pathology , receptor , alternative medicine
Diabet. Med. 29, 359–365 (2012) Abstract Aims To observe the effects of pioglitazone on coronary plaque area, plaque burden, serum high‐sensitivity C‐reactive protein, adiponectin and plasma endothelin‐1 levels in patients with impaired glucose tolerance and coronary borderline lesions. Methods Thirty patients were randomly divided into two groups: a pioglitazone group and a control group. The latter was administered placebo in addition to standard therapy; the former pioglitazone 15 mg/d in addition to standard therapy. Before treatment and 6 months later, left ventricular ejection fraction, serum lipid profile, high‐sensitivity C‐reactive protein, adiponectin and plasma endothelin‐1 levels were detected. Coronary plaque area and plaque burden were examined using intravascular ultrasound. Results No significant differences were found in left ventricular ejection fraction and serum lipid levels pre‐ and post‐trial. Compared with the control group, 6 months’ treatment with pioglitazone significantly decreased coronary plaque burden (50.7 ± 11.1 vs. 64.1 ± 10.3%, P < 0.05), plaque area (6.22 ± 2.03 vs. 8.31 ± 4.29, P < 0.05), thin‐cap fibroatheroma prevalence (11 vs. 22%, P < 0.05) and percentage of necrotic core area (16 ± 8 vs. 31 ± 7%, P < 0.05). Compared with the control group, serum high‐sensitivity C‐reactive protein and plasma endothelin‐1 levels were significantly lower and adiponectin level significantly higher in patients in the pioglitazone group. Serum adiponectin level was negatively correlated with plasma endothelin‐1 level and coronary plaque area ( r = 0.739 and –0.431, respectively, both P < 0.05). Conclusions Pioglitazone may induce regression and stabilization of coronary atherosclerotic plaques. The mechanisms might involve inhibition of inflammation, increase in adiponectin level and improvement in endothelial function.