Document Detail


Pilot study of pioglitazone and exercise training effects on basal myocardial substrate metabolism and left ventricular function in HIV-positive individuals with metabolic complications.
MedLine Citation:
PMID:  24334183     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Individuals with HIV infection and peripheral metabolic complications have impaired basal myocardial insulin sensitivity that is related to left ventricular (LV) diastolic dysfunction. It is unknown whether interventions shown to be effective in improving peripheral insulin sensitivity can improve basal myocardial insulin sensitivity and diastolic function in people with HIV and peripheral metabolic complications.
OBJECTIVE: In a pilot study, we evaluated whether the peroxisome proliferator-activated receptor-gamma (PPAR-γ) agonist pioglitazone or combined endurance and resistance exercise training improves basal myocardial insulin sensitivity and diastolic function in HIV+ adults with peripheral metabolic complications.
DESIGN: Twenty-four HIV+ adults with metabolic complications including peripheral insulin resistance were randomly assigned to 4 months of pioglitazone (PIO; 30 mg/d) or supervised, progressive endurance and resistance exercise training (EXS; 90-120 min/d, 3 d/wk). Basal myocardial substrate metabolism was quantified by radioisotope tracer methodology and positron emission tomography (PET) imaging, and LV function was measured by echocardiography.
RESULTS: Twenty participants completed the study. Neither PIO nor EXS resulted in a detectable improvement in basal myocardial insulin sensitivity or diastolic function. Post hoc analyses revealed sample sizes of more than 100 participants are needed to detect significant effects of these interventions on basal myocardial insulin sensitivity and function.
CONCLUSIONS: PIO or EXS alone did not significantly increase basal myocardial insulin sensitivity or LV diastolic function in HIV+ individuals with peripheral metabolic complications.
Authors:
W Todd Cade; Dominic N Reeds; E Turner Overton; Pilar Herrero; Alan D Waggoner; Erin Laciny; Coco Bopp; Sherry Lassa-Claxton; Robert J Gropler; Linda R Peterson; Kevin E Yarasheski
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  HIV clinical trials     Volume:  14     ISSN:  1528-4336     ISO Abbreviation:  HIV Clin Trials     Publication Date:    2013 Nov-Dec
Date Detail:
Created Date:  2013-12-16     Completed Date:  2014-01-30     Revised Date:  2014-03-19    
Medline Journal Info:
Nlm Unique ID:  100936377     Medline TA:  HIV Clin Trials     Country:  United States    
Other Details:
Languages:  eng     Pagination:  303-12     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Exercise*
Female
HIV Infections / complications*,  metabolism,  physiopathology
Humans
Hypoglycemic Agents / therapeutic use*
Insulin Resistance / physiology
Male
Myocardium / metabolism*
Pilot Projects
Prospective Studies
Thiazolidinediones / therapeutic use*
Ventricular Function, Left / physiology*
Grant Support
ID/Acronym/Agency:
AI069495/AI/NIAID NIH HHS; AT003083/AT/NCCAM NIH HHS; DK020579/DK/NIDDK NIH HHS; DK049393/DK/NIDDK NIH HHS; DK056341/DK/NIDDK NIH HHS; DK059531/DK/NIDDK NIH HHS; DK074343/DK/NIDDK NIH HHS; K01 DK074343/DK/NIDDK NIH HHS; K23 RR019508/RR/NCRR NIH HHS; M01 RR000036/RR/NCRR NIH HHS; P30 DK020579/DK/NIDDK NIH HHS; P30 DK056341/DK/NIDDK NIH HHS; P30DK056341/DK/NIDDK NIH HHS; P41 RR000954/RR/NCRR NIH HHS; P60 DK020579/DK/NIDDK NIH HHS; R01 DK049393/DK/NIDDK NIH HHS; R01 DK059531/DK/NIDDK NIH HHS; R21 AT003083/AT/NCCAM NIH HHS; R56 DK049393/DK/NIDDK NIH HHS; RR000954/RR/NCRR NIH HHS; RR019508/RR/NCRR NIH HHS; RR024992/RR/NCRR NIH HHS; U01 AI069495/AI/NIAID NIH HHS; UL1 RR024992/RR/NCRR NIH HHS; UL1 TR000448/TR/NCATS NIH HHS
Chemical
Reg. No./Substance:
0/Hypoglycemic Agents; 0/Thiazolidinediones; X4OV71U42S/pioglitazone
Comments/Corrections

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


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