Journal List > J Korean Diabetes Assoc > v.30(2) > 1062421

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Park, Lee, Kim, Kim, Park, Ahn, Lee, Kim, Won, Ha, Kwak, Cha, Lim, Kim, and Lee: Effects of Pioglitazone on Cerebral Hemodynamics in Patients of Type 2 Diabetes
Original Article
The Journal of Korean Diabetes Association

The Journal of Korean Diabetes Association 2006; 30(2): 96-103.

Published online: 31 March 2006

DOI: https://doi.org/10.4093/jkda.2006.30.2.96

Effects of Pioglitazone on Cerebral Hemodynamics in Patients of Type 2 Diabetes

Jong Suk Park, You Jung Lee1, Chul Sik Kim, Hai Jin Kim, Jina Park, Chul Woo Ahn, Kyung Yul Lee2, Hyeong Jin Kim3, Young Jun Won3, Hun Ju Ha1, Hae Sun Kwak1, Bong Soo Cha, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

1Ewha Graduate School of Clinical Health Science, Seoul, Korea.

2Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.

3Department of Internal Medicine, Kwandong University College of Medicine, Gangneung, Korea.

Received 13 January 2006       Accepted 14 March 2006

Copyright © 2006 Korean Diabetes Association

Abstract

Background

Atherosclerosis is one of the major causes of morbidity and mortality in patients with type 2 diabetes and pioglitazone has been reported to have antiatherogenic effect. The aim of this study was to investigate whether pioglitazone affects carotid intima-media thickness (IMT) and pulsatility index (PI) in type 2 diabetic patients.

Methods

A total of 40 type 2 diabetic patients were included and divided into two groups: the pioglitazone-treated group (pioglitazone 15 mg/day with gliclazide 80~320 mg/day for 12 weeks) (n = 20) and control group (gliclazide 80~320 mg/day for 12 weeks) (n = 20). The changes in lipid profile, insulin resistance, IMT, and PI were monitored to determine that pioglitazone improves cerebrovascular blood flow.

Results

The pioglitazone treatment significantly increased HDL-C, reduced triglyceride, insulin resistance and PI. IMT tended to decrease but the change was not significant. This study revealed that treatment with pioglitazone was associated with the improvement of cerebrovascular blood flow.

Conclusions

Pioglitazone appears to be effective for the improvement of cerebrovascular blood flow in type 2 diabetic patients.

Keywords: IMT (intima-media thickness), PI (pulsatility index), Pioglitazone, Type 2 diabetes

Figures and Tables

Fig. 1
BA PI and mean MCA PI are decreased significantly in pioglitazone treated group. BA, basilar artery MCA, middle cerebral artery; PI, pulsatility index.
*P < 0.05 before vs. after treatment in each group.
jkda-30-96-g001
Table 1
Baseline Clinical Characteristics of Study Subjects
jkda-30-96-i001

PIO, pioglitazone; BMI, body mass index; DM, diabetes mellitus; BP, blood pressure; PHx, past history; CVD, cerebrovascular disease; CAOD, coronary artery occlusive diease. There was no statistically significant differences between the groups (P > 0.05).

Table 2
Baseline Biochemical Characteristics of Study Subjects
jkda-30-96-i002

PIO, pioglitazone; TC, total cholesterol; TG, triglyceride; HDL-C, high density lipoprotein-cholesterol; LDL-C, low density lipoprotein cholesterol; FFA, free fatty acid; PAI-1, plasminogen activator inhibitor-1; ISI, insulin sensitivity index; HOMA-IR, homeostasis model assessment of insulin resistance. There was no statistically significant differences between the groups (P > 0.05).

Table 3
Changes in Clinical and Biochemical Characteristics
jkda-30-96-i003

*P < 0.05 before vs. after treatment in each group.

Table 4
Changes in Insulin Sensitivity and Resistance
jkda-30-96-i004

*P < 0.05 before vs. after treatment in each group

Table 5
Changes in IMT
jkda-30-96-i005

Lt, left; Rt, right; AVG, average; MAX, maximum; IMT, intima-media thickness. There was no significant difference after treatment in both groups (P > 0.05).

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