J Korean Diabetes Assoc JKDA The Journal of Korean Diabetes Association 1015-6461 Korean Diabetes Association 10.4093/jkda.2006.30.2.96 Original Article Effects of Pioglitazone on Cerebral Hemodynamics in Patients of Type 2 Diabetes Park Jong Suk Lee You Jung 1 Kim Chul Sik Kim Hai Jin Park Jina Ahn Chul Woo Lee Kyung Yul 2 Kim Hyeong Jin 3 Won Young Jun 3 Ha Hun Ju 1 Kwak Hae Sun 1 Cha Bong Soo Lim Sung Kil Kim Kyung Rae Lee Hyun Chul Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. Ewha Graduate School of Clinical Health Science, Seoul, Korea. Department of Neurology, Yonsei University College of Medicine, Seoul, Korea. Department of Internal Medicine, Kwandong University College of Medicine, Gangneung, Korea. 03 2006 31 03 2006 30 2 96 103 13 01 2006 14 03 2006 Copyright © 2006 Korean Diabetes Association 2006 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.

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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.

Baseline Clinical Characteristics of Study Subjects

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).

Baseline Biochemical Characteristics of Study Subjects

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).

Changes in Clinical and Biochemical Characteristics

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

Changes in Insulin Sensitivity and Resistance

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

Changes in IMT

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).