Document Detail


Metformin, but not pioglitazone, decreases postchallenge plasma ghrelin levels in type 2 diabetic patients: a possible role in weight stability?
MedLine Citation:
PMID:  18355332     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Effects of metformin and pioglitazone on body weight are clearly different. Recently, the role of ghrelin, an orexigenic peptide derived from stomach, has been appreciated. Plasma ghrelin levels display a preprandial peak and postprandial suppression, suggesting its physiological role. We hypothesized that metformin or pioglitazone may modulate circulating ghrelin levels and this modulation may be related to differential effects on body weight with these agents. METHODS: Thirty-five Japanese type 2 diabetic patients [21 men and 14 women, age 62 +/- 2 years, body mass index (BMI) 26.6 +/- 0.5 kg/m(2) and haemoglobin A1c (HbA1c) 8.2 +/- 0.1%, mean +/- s.e.] were randomly assigned to groups for the addition of metformin or pioglitazone. At baseline and 4 months later, a 75-g oral glucose tolerance test (OGTT) was performed to measure plasma ghrelin levels. RESULTS: In 33 subjects who completed the study, the overall decrease in HbA1c ( approximately 1%) was comparable between the two groups. As expected, BMI increased in the pioglitazone group but not in the metformin group. After the treatment, plasma ghrelin levels at each point of OGTT remained unchanged in the pioglitazone group. In the metformin group, fasting ghrelin levels were unaltered, whereas the absolute levels at 30, 60 and 120 min decreased significantly. The area under the curve for the 2-h ghrelin profile also decreased significantly. CONCLUSIONS: Metformin, but not pioglitazone, decreased plasma ghrelin levels after the glucose load. This decrease may in part account for weight stability in type 2 diabetic patients treated with metformin.
Authors:
I Kusaka; S Nagasaka; H Horie; S Ishibashi
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2008-03-18
Journal Detail:
Title:  Diabetes, obesity & metabolism     Volume:  10     ISSN:  1463-1326     ISO Abbreviation:  Diabetes Obes Metab     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-12-02     Completed Date:  2009-08-20     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  100883645     Medline TA:  Diabetes Obes Metab     Country:  England    
Other Details:
Languages:  eng     Pagination:  1039-46     Citation Subset:  IM    
Affiliation:
Division of Endocrinology and Metabolism, Department of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan.
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MeSH Terms
Descriptor/Qualifier:
Area Under Curve
Blood Glucose / analysis
Body Mass Index
Body Weight / drug effects,  physiology
Diabetes Mellitus, Type 2 / blood*
Female
Ghrelin / blood*
Glucose Tolerance Test
Hemoglobin A, Glycosylated / analysis
Humans
Hypoglycemic Agents / therapeutic use*
Insulin / blood
Male
Metformin / therapeutic use*
Middle Aged
Statistics, Nonparametric
Thiazolidinediones / therapeutic use*
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Ghrelin; 0/Hemoglobin A, Glycosylated; 0/Hypoglycemic Agents; 0/Thiazolidinediones; 11061-68-0/Insulin; 111025-46-8/pioglitazone; 657-24-9/Metformin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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