Differential effect of pioglitazone (PGZ) and rosiglitazone (RGZ) on postprandial glucose and lipid metabolism in patients with type 2 diabetes mellitus: a prospective, randomized crossover study
Differential effect of pioglitazone (PGZ) and rosiglitazone (RGZ) on postprandial glucose and lipid metabolism in patients with type 2 diabetes mellitus: a prospective, randomized crossover study
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DOI：
10.1002/dmrr.715
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发表时间：
2007-07-01
影响因子：
8
通讯作者：
Christ, Emanuel R.
中科院分区：
文献类型：
--
作者：
Chappuis, Bernard;Braun, Monika;Christ, Emanuel R.
背景2型糖尿病（T2 Dm）患者的餐后代谢受损。两种噻唑烷二酮类药物吡格列酮（PGZ）和罗格列酮（RGZ）对血糖控制的作用相似，但对空腹血脂的作用不同。本研究探讨RGZ和PGZ对餐后代谢的影响，在前瞻性，随机crossover trial.Methods 17例T2 DM患者随机分为RGZ或PGZ为12周，8周的洗脱期。采集空腹血样，测定血糖（FPG）、胰岛素、HbA（1c）、脂质、载脂蛋白（apo）、脂蛋白（LPL）和肝脂肪酶（HL）以及胆固醇酯转移蛋白（CETP）活性。一个标准化的早餐和餐后血糖，胰岛素，和脂质亚组份profilesdetermined.Results RGZ和PGZ治疗导致类似的改善FPG，HbA（1c）和稳态模型评估。PGZ治疗后空腹和餐后甘油三酯（TG）水平显著降低（空腹：-0.35 vs 0.44 mmol/L; p < 0.04;餐后AUC-TG：-195.6 vs 127.9 mmol/L/min; p < 0.02）与VLDL-2-TG变化相关（-0.10 vs 0.21 mmol/L; p = 0.23）和VLDL-3-TG（0.0 vs 0.34 mmol/L; p < 0.04）。与PGZ相比，RGZ组空腹胆固醇增加（0.06 vs 0.59 mmol/L; p < 0.04），特别是VLDL-2-C（-0.30 vs 0.59 mmol/L; p < 0.03）和VLDL-3-C（-0.85 vs 2.11 mmol/L; p < 0.02）。RGZ后餐后VLDL脂质和蛋白含量增加，PGZ后降低。空腹apoB、apoA-I、apoC-II/C-III比值和LPL活性无差异。CETP活性RGZ后下降，PGZ后上升（-6.2vs4.2p/mol/mL/min; p < 0.002）。PGZ对脂质代谢的额外有益作用可能与其对胰岛素非依赖性VLDL产生和CETP活性的影响有关。版权所有（c）2007约翰威利父子有限公司。
Background Postprandial metabolism is impaired in patients with type 2 diabetes (T2Dm). Two thiazolidinediones pioglitazone (PGZ) and rosiglitazone (RGZ) have similar effects on glycaemic control but differ in their effects on fasting lipids. This study investigated the effects of RGZ and PGZ on postprandial metabolism in a prospective, randomized crossover trial.Methods Seventeen patients with T2Dm were randomized to RGZ or PGZ for 12 weeks, with an 8-week wash-out period. Fasting blood samples were taken for glucose (FPG), insulin, HbA(1c), lipids, apolipoproteins (apo), lipoprotein (LPL) and hepatic lipase (HL), and cholesterol ester transfer protein (CETP) activity. A standardized breakfast was served and postprandial glucose, insulin, and lipid subfraction profiles were determined.Results RGZ and PGZ treatment resulted in a similar improvement in FPG, HbA(1c) and homeostasis model assessment. Fasting and postprandial triglyceride (TG) levels were significantly lower following PGZ therapy (fasting: -0.35 vs 0.44 mmol/L; p < 0.04; postprandial AUC-TG: -195.6 vs 127.9 mmol/L/min; p < 0.02) associated with changes in VLDL-2-TG (-0.10 vs 0.21 mmol/L; p = 0.23) and VLDL-3-TG (0.0 vs 0.34 mmol/L; p < 0.04). Fasting cholesterol increased with RGZ compared to PGZ (0.06 vs 0.59 mmol/L; p < 0.04), particularly in VLDL-2-C (-0.30 vs 0.59 mmol/L; p < 0.03) and VLDL-3-C (-0.85 vs 2.11 mmol/L; p < 0.02). Postprandial VLDL lipid and protein content increased after RGZ and decreased after PGZ. Fasting apoB, apoA-I, apoC-II/C-III-ratio, and LPL activity did not differ. CETP activity decreased after RGZ and increased after PGZ (-6.2 vs 4.2 p/mol/mL/min; p < 0.002).Conclusions Both the glitazones had similar effects on glucose metabolism. The additional beneficial effect of PGZ on lipid metabolism may be related to its effects on insulin-independent VLDL production and CETP activity. Copyright (c) 2007 John Wiley & Sons, Ltd.