| Abstract | The aim of the study was to assess the effects of the combination of metformin plus pioglitazone or rosiglitazone on glucose and blood pressure in type 2 diabetic patients with metabolic syndrome, as well as its tolerability in those patients. In this 12-month, multicentric, double-blind, randomized, controlled, parallel-group trial, all patients began with metformin. Patients were randomized for self-administration of either pioglitazone or rosiglitazone for 12 months. We assessed body mass index (BMI), glycemic control (glycosylated hemoglobin [HbA(1c)], fasting and postprandial plasma glucose and insulin levels [FPG, PPG, FPI and PPI, respectively] and homeostasis model assessment [HOMA] index) and systolic and diastolic blood pressure (SBP and DBP, respectively), at baseline and at 3, 6, 9 and 12 months of treatment, as well as high-sensitivity C-reactive protein (hs-CRP), nitrites/nitrates and adiponectin (ADN) at baseline and at 12 months of treatment. Significant HbA(1c) decreases were obtained after 9 (p<0.05) and 12 (p<0.01) months in both groups. After 9 and 12 months, mean FPG and PPG levels were decreased in both groups (p<0.05 and p<0.01, respectively). We observed decreases in FPI and PPI at 9 and 12 months (p<0.05 and p<0.01, respectively) compared to the baseline values in both groups. Furthermore, HOMA index improvement over the baseline value was obtained only at 12 months (p<0.05) in both groups. SBP and DBP improved significantly (p<0.05, for each) in both groups after 12 months. hs-CRP decreased significantly (p<0.05) in both groups after 12 months; nitrites/nitrates and ADN increased significantly (p<0.05, for each) in both groups after 12 months. The combination of thiazolinediones and metformin is associated with a slight but significant improvement in the long-term blood pressure control of these patients, and with an improvement in the anti-inflammatory state, both of which are related to a similar reduction in insulin-resistance. |
| Authors | Giuseppe Derosa, Elena Fogari, Arrigo F G Cicero, Angela D'Angelo, Leonardina Ciccarelli, Mario N Piccinni, Fabio Pricolo, Sibilla A T Salvadeo, Alessia Gravina, Ilaria Ferrari, Roberto Fogari
(Affiliation: Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy. giuseppe.derosa at unipv.it)
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| Journal | Hypertension research : official journal of the Japanese Society of Hypertension
(Hypertens Res)
Vol. 30
Issue 5
Pg. 387-94
(May 2007)
ISSN: 0916-9636 Japan |
| PMID | 17587750
(Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)
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| Chemical References |
- Biological Markers
- Blood Glucose
- Hemoglobin A, Glycosylated
- Hypoglycemic Agents
- Thiazolidinediones
- Insulin
- pioglitazone
- rosiglitazone
- Metformin
|
| Topics |
- Biological Markers
(blood)
- Blood Glucose
(drug effects, metabolism)
- Blood Pressure
(drug effects)
- Body Mass Index
- Diabetes Mellitus, Type 2
(drug therapy, immunology)
- Female
- Hemoglobin A, Glycosylated
(metabolism)
- Humans
- Hypertension
(drug therapy, immunology)
- Hypoglycemic Agents
(administration & dosage)
- Insulin
(blood)
- Male
- Metformin
(administration & dosage)
- Middle Aged
- Thiazolidinediones
(administration & dosage)
- Treatment Outcome
|
