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Effects of pioglitazone vs metformin on circulating endothelial microparticles and progenitor cells in patients with newly diagnosed type 2 diabetes - a randomized controlled trial.
MedLine Citation:
PMID:  21255215     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aim: Endothelial microparticles (EMPs) and endothelial progenitor cells (EPCs) are markers of endothelial injury and repair. We compared the effects of pioglitazone versus metformin on the circulating numbers of EMPs and EPCs in patients with newly-diagnosed type 2 diabetes. Methods: This was a randomized, double-blind, comparator-controlled, 24-week single-center trial conducted in a Teaching Hospital in Naples, Italy. One hundred and ten people with newly diagnosed type 2 diabetes who were never treated with antihyperglycemic drugs and had hemoglobin A1c (HbA1c) levels between 7 and 10%, were given Pioglitazone hydrochloride (15-45 mg/d) (n = 55) or metformin (1000-2000 mg/d) (n = 55) as an active comparator. Absolute change from baseline to final visit in circulating EMPs and EPCs, and their ratio were the primary outcomes. Results: Baseline characteristics did not differ between the study groups. The decrease of circulating EMPsCD31+ (intergroup difference, -32 counts/μL [95% CI, -51 to -9]), and the increase of EPCsCD34+KDR+ (intergroup difference, 33 cells/10(6) events [CI, 13 to 55]) was greater with pioglitazone vs metformin. EMPS/EPCs ratio was reduced with pioglitazone and unchanged with metformin (difference, -1.5 [CI, -2.6 to -0.5], P < 0.001). Participants assigned to pioglitazone gained more weight and experienced greater improvements in some coronary risk measures (HDL-cholesterol, triglycerides, adiponectin, and C-reactive protein) than did those assigned to metformin. Conclusion: Compared with metformin, pioglitazone treatment improved the imbalance between endothelial damage and repair capacity, and led to more favorable changes in coronary risk factors in patients with newly-diagnosed type 2 diabetes.
Authors:
K Esposito; M I Maiorino; C Di Palo; M Gicchino; M Petrizzo; G Bellastella; F Saccomanno; D Giugliano
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-21
Journal Detail:
Title:  Diabetes, obesity & metabolism     Volume:  -     ISSN:  1463-1326     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-1-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883645     Medline TA:  Diabetes Obes Metab     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 John Wiley & Sons A/S.
Affiliation:
1Department of Geriatrics and Metabolic Diseases, Azienda Universitaria Policlinico, Second University of Naples, Naples, Italy.
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