Effect of pioglitazone on carotid intima-media thickness and arterial stiffness in type 2 diabetic nephropathy patients

Nakamura, Tsukasa; Matsuda, Takemasa; Kawagoe, Yasuhiro; Ogawa, Hiroshi; Takahashi, Yutaka; Sekizuka, Keiko; Koide, Hikaru

doi:10.1016/j.metabol.2004.05.013

Cited by 113 publications

(77 citation statements)

References 34 publications

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“…Similarly, Mazzone et al [13] demonstrated that pioglitazone slowed CIMT progression compared to glimepiride in type 2 diabetic patients (mean age of 60 years) over an 18-month treatment period. Pioglitazone has also been shown to reduce CIMT in normotensive type 2 diabetic patients with nephropathy [11]. Our results extend these findings to a relatively young population and demonstrate the potential for pioglitazone to modify atherosclerosis progression at a relatively young age and early stage of the disease.…”

Section: Discussionsupporting

confidence: 80%

“…Clinically, thiazolidinediones (TZDs) have had little [7] or no [8] beneficial effects on the risk of acute cardiovascular events in cohorts with average ages in the 50-60s or higher. On the other hand, at least three members of the class have been shown to reduce carotid intima-media thickness in individuals with established diabetes [9][10][11][12][13][14] and in nondiabetic individuals with known coronary disease [15]. Reasons for the apparent dissociation between promising mechanistic and CIMT effects of TZDs and their lack of impact on clinical cardiovascular events remain unexplained, but could be due to a dissociation between antiatherogenic effects of the drugs and their impact on mechanisms for acute arterial occlusion.…”

Section: Introductionmentioning

confidence: 99%

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Effect of pioglitazone on progression of subclinical atherosclerosis in non-diabetic premenopausal Hispanic women with prior gestational diabetes

Xiang¹,

Hodis²,

Kawakubo³

et al. 2008

Atherosclerosis

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The Pioglitazone in the Prevention of Diabetes (PIPOD) study was a single arm 3-year open-label pioglitazone treatment to determine the effects of pioglitazone in women with prior gestational diabetes mellitus (GDM) who had completed the Troglitazone in the Prevention of Diabetes (TRIPOD) study. Here we report the results on progression of subclinical atherosclerosis, measured by carotid intima-media thickness (CIMT) in non-diabetic women. Data were analyzed to compare CIMT progression rates during pioglitazone treatment to rates that had been observed during either placebo or troglitazone treatment in the TRIPOD study. Sixty-one women met the entry criteria with mean age of 40 years. In the 30 women who came to PIPOD from the placebo arm of TRIPOD, the CIMT rate was 69% lower during pioglitazone treatment than it had been during placebo (0.0031 vs. 0.0100 mm/yr, p=0.006). In the 31 women who came to PIPOD from the troglitazone arm of TRIPOD, CIMT rate was 38% lower during pioglitazone than it had been during troglitazone, a difference that was not statistically significant (0.0037 vs. 0.0060 mm/year; p=0.26). Adjustment for differences in baseline characteristics and potential on-trial confounders did not alter the conclusion but did increase the CIMT rates differences slightly. We conclude that treatment with pioglitazone slowed CIMT progression in women who had been on placebo in the TRIPOD study and maintained a relatively low rate of progression in women who had been on troglitazone. Pioglitazone slows progression of subclinical atherosclerosis in young Hispanic women at increased risk for type 2 diabetes.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Effect of pioglitazone on progression of subclinical atherosclerosis in non-diabetic premenopausal Hispanic women with prior gestational diabetes

Xiang¹,

Hodis²,

Kawakubo³

et al. 2008

Atherosclerosis

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“…Interestingly, administration of lipid-lowering agents 36,37 and a type of oral hypoglycemic agent had a significant effect in reducing PWV in normolipidemic and normotensive individuals. 38 Of most importance, although PWV improves with blood pressure treatment, the medication impact on PWV is apparently independent of blood pressure reduction.…”

Section: Discussionmentioning

confidence: 99%

Better Management of Cardiovascular Diseases by Pulse Wave Velocity: Combining Clinical Practice with Clinical Research using Evidence-Based Medicine

Khoshdel¹,

Carney²,

Nair³

et al. 2007

Clinical Medicine & Research

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Arterial stiffness measured by pulse wave velocity (PWV) is an accepted strong, independent predictor of cardiovascular events and mortality. However, lack of a reliable reference range has limited its use in clinical practice. In this evidence-based review, we applied published data to develop a PWV risk stratification model and demonstrated its impact on the management of common clinical scenarios. After reviewing 97 studies where PWV was measured, 5 end-stage renal disease patients, 5 hypertensives, 2 diabetics, and 2 elderly studies were selected. Pooling the data by the "fixed-effect model" demonstrated that the mortality and cardiovascular event risk ratio for one level increment in PWV was 2.41 (1.81-3.20) or 1.69 (1.35-2.11), respectively.There was a significant difference in PWV between survived and deceased groups, both in the low and high risk populations. Furthermore, risk comparison demonstrated that 1 standard deviation increment in PWV is equivalent to 10 years of aging, or 1.5 to 2 times the risk of a 10 mmHg increase in systolic blood pressure. Evidence shows that PWV can be beneficially used in clinical practice for cardiovascular risk stratification. Furthermore, the above risk estimates could be incorporated into currently used cardiac risk scores to improve their predictive power and facilitate the clinical application of PWV.

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“…Therapy with pioglitazone, 30 mg/day, was accompanied by a significant reduction in UAE in 15 normotensive type 2 diabetic patients with microalbuminuria by about 40% and 69% at 6 and 12 months of therapy, respectively. At 12 months, UAE was also significantly lower in pioglitazone-treated patients in comparison with those treated with glibenclamide and voglibose (77). More recently, Agarwal et al (78) reported the result of a randomised, open-label, study comparing glipizide with pioglitazone over 16 weeks in 44 type 2 diabetic patients with overt diabetic nephropathy.…”

Section: Diabetic Nephropathymentioning

confidence: 98%

Peroxisome proliferator-activated receptor gamma agonists in renal disease

Iglesias

Díez

2006

eur j endocrinol

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Type 2 diabetes is a well recognised cause of chronic renal failure (CRF). Only few oral antidiabetic drugs can be used for treating type 2 diabetes in patients with CRF. Among them are repaglinide, a rapid-acting prandial insulin releaser, and peroxisome proliferator-activated receptor gamma (PPARg) agonists, such as rosiglitazone and pioglitazone. These compounds are metabolised in the liver, therefore accumulation of the drug and the risk of severe and prolonged hypoglycaemia are minimised. PPARg receptors are expressed in many tissues including the kidney. Recently, numerous healthful effects of PPARg agonists on several aspects related to renal function have been increasingly reported. These drugs have shown to possess many advantageous anti-inflammatory, haemodynamic, vascular and metabolic effects. In the present paper we have reviewed the more recent experimental studies that evaluated these potential beneficial effects of PPARg agonists on renal function and revised the results of their utilisation in patients with different degrees of renal impairment, in dialysis patients, and in patients with diabetes mellitus after kidney transplantation. Finally, tolerability and safety profile of PPARg agonists in patients with reduced glomerular filtration rate are also analysed. European Journal of Endocrinology 154 613-621

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Effect of pioglitazone on carotid intima-media thickness and arterial stiffness in type 2 diabetic nephropathy patients

Cited by 113 publications

References 34 publications

Effect of pioglitazone on progression of subclinical atherosclerosis in non-diabetic premenopausal Hispanic women with prior gestational diabetes

Effect of pioglitazone on progression of subclinical atherosclerosis in non-diabetic premenopausal Hispanic women with prior gestational diabetes

Better Management of Cardiovascular Diseases by Pulse Wave Velocity: Combining Clinical Practice with Clinical Research using Evidence-Based Medicine

Peroxisome proliferator-activated receptor gamma agonists in renal disease

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