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The effects of rosiglitazone and metformin on inflammation and endothelial dysfunction in patients with type 2 diabetes mellitus.

Abstract
Diabetic patients have a markedly increased risk of cardiovascular disease compared with non-diabetics. Two drug groups today target insulin resistance; biguanides and thiazolidinediones. In addition, these may have other effects on cardiovascular risk factors. The aim of this study was to evaluate the effects of metformin and rosiglitazone on non-traditional cardiovascular risk factors. Forty type 2 diabetic patients were randomized into metformin and rosiglitazone groups. After receiving the optimal doses, the patients were monitored for 12 weeks. Biochemical parameters, lipid parameters, CRP, insulin, c-peptide, and HbA1c levels were analyzed. VWF, PAI-1, ICAM-1, TNF-α, IL-6, E-selectin, and fibrinogen levels were measured in order to assess coagulation status and endothelial dysfunction. In the metformin group, body mass index, PPG, HbA1c, IL-6, ICAM-1, and TNF-α levels were significantly decreased after 12 weeks compared with the basal levels. IL-6 levels decreased from 75 pg/ml ± 20 to 42 pg/ml ± 9 (P 0.023) and TNF- α levels from 61 pg/ml ± 31 to 39 pg/ml ± 10 (P 0.018). In the rosiglitazone group, FPG, PPG, HbA1c, insulin, HOMA-IR, IL-6, and TNF-α levels decreased significantly after 12 weeks compared with the basal levels. IL-6 levels decreased from 78 pg/ml ± 21 to 41 pg/ml ± 9 (P 0.028) and TNF-α levels from 62 pg/ml ± 19 to 37 pg/ml ± 10 (P 0.012). At the end of the study, no significant differences were determined between groups. Insulin resistance and type 2 diabetes are strongly associated with low grade inflammation. Both metformin and rosiglitazone were effective in controlling inflammatory markers in addition to metabolic parameters.
AuthorsEvren Fidan, H Onder Ersoz, Mustafa Yilmaz, Hulya Yilmaz, Mustafa Kocak, Caner Karahan, Cihangir Erem
JournalActa diabetologica (Acta Diabetol) Vol. 48 Issue 4 Pg. 297-302 (Dec 2011) ISSN: 1432-5233 [Electronic] Germany
PMID21424914 (Publication Type: Journal Article, Randomized Controlled Trial)
Chemical References
  • C-Peptide
  • Interleukin-6
  • Thiazolidinediones
  • Tumor Necrosis Factor-alpha
  • Rosiglitazone
  • Metformin
Topics
  • Adult
  • C-Peptide (immunology)
  • Cardiovascular Diseases (epidemiology, etiology, immunology, physiopathology)
  • Diabetes Mellitus, Type 2 (complications, drug therapy, metabolism)
  • Endothelial Cells (drug effects, immunology)
  • Female
  • Humans
  • Interleukin-6 (immunology)
  • Male
  • Metformin (therapeutic use)
  • Middle Aged
  • Rosiglitazone
  • Thiazolidinediones (therapeutic use)
  • Tumor Necrosis Factor-alpha (immunology)

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