Clinical Diabetes 2006;7(4):358-367.
제2형 당뇨병환자에서 pioglitazone 15 mg 치료의 경동맥 내중막 두께에 대한 효과
조민호, 유재명, 문홍주, 강준구, 이병완, 이성진, 홍은경, 김현규, 김두만, 임성희, 최문기, 유형준
Effect to Carotid Intima-media Thickness in Type 2 Diabetic Patients after Pioglitazone 15 mg Therapy
Min Ho Cho, Jae Myung Yu, Hong Ju Moon, Jun Goo Kang, Byung Wan Lee, Sung Jin Lee, Eun Gyoung Hong, Hyun Kyu Kim, Doo Man Kim, Sung Hee Ihm, Mun Ki Choi, Hyung-Joon Yoo
Abstract
Background
Carotid intima-media thickness (cIMT) is a strong predictor of macrovascular disease. Pioglitazone has been reported to have antiatherogenic effect and anti-inflammatory effect. But the dose of pioglitazone in previous clinical trial was 30 mg or 45 mg daily. This study was performed to assess the effect of pioglitazone 15 mg, which has been commercially used dose in Korea, to carotid intima-media thickness. Method: A 12 weeks, open-label, prospective, controlled clinical study was done. Patients were randomized to pioglitazone 15mg administerd group or control group. Biochemical and clinical markers was assessed including cIMT, fasting glucose, insulin, lipids, high sensitivity C-reactive protein (hsCRP), fibrinogen, and HbA1c. Result: The study was completed by 88 patients (48 pioglitazone group, 40 control group). There were no difference baseline characteristics between two groups. The average and maximal cIMT were reduced only in the pioglitazone group after 12 weeks (-0.043 ± 0.109 vs 0.006 ± 0.105 mm, -0.052 ± 0.127 vs 0.002 ± 0.127mm P < 0.05). And fasting serum insulin, HOMA-IR, hsCRP, and triglyceride levels were improved only in pioglitazone group. Conclusions: There were a regression of cIMT, a decrease of hsCRP and an improvement of HOMA-IR after pioglitazone 15 mg therapy. This result implies pioglitazone 15 mg has an anti-inflammatory effect and an antiatherogenic effect too.
Key Words: Carotid intima-media thickness, Pioglitazone


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