Effects of Pioglitazone on Asymmetric Dimethylarginine and Components of the Metabolic Syndrome in Nondiabetic Patients (EPICAMP Study): A Double-Blind, Randomized Clinical Trial

Shokouh, Pedram; Joharimoghadam, Adel; Roohafza, Hamidreza; Sadeghi, Masoumeh; Golabchi, Allahyar; Boshtam, Maryam; Sarrafzadegan, Nizal

doi:10.1155/2013/358074

Cited by 6 publications

(6 citation statements)

References 44 publications

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“…In the present study, the antihypertensive effect of pioglitazone isn't related to NO levels that run with results of (Shokouh et al 2013) who found insignificant change in Asymmetric Dimethylarginine (ADMA), the principal endogenous NOS inhibitor, in non-diabetic MS patients treated by pioglitazone.…”

Section: Dyslipidaemiasupporting

confidence: 78%

Effects of telmisartan and pioglitazone on high fructose induced metabolic syndrome in rats

Shahataa

Mostafa‐Hedeab

Ali

et al. 2016

Can. J. Physiol. Pharmacol.

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Section: Dyslipidaemiasupporting

confidence: 78%

Effects of telmisartan and pioglitazone on high fructose induced metabolic syndrome in rats

Shahataa

Mostafa‐Hedeab

Ali

et al. 2016

Can. J. Physiol. Pharmacol.

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“…This paper is presenting the findings of psychiatric part of the EPICAMP (effects of pioglitazone on cardiac structure, markers of endothelial function, and psychological status) study, a trial aimed at investigating the efficacy of pioglitazone monotherapy in improving a number of cardiovascular and psychiatric indices in a group of nondiabetic MetS patients. The results of the other part of this study have been reported previously [ 19 ]. The purpose of designing this part was to elucidate the effects of pioglitazone on the mental status of the participants.…”

Section: Introductionsupporting

confidence: 80%

“…The changes of HOMA-IR score in pioglitazone group were not correlated with the changes in depression score ( r = 0.144; P = 0.145). It is worth noting that our findings regarding the indices of glucose and lipid metabolism have been described in detail elsewhere [ 19 ].…”

Section: Resultsmentioning

confidence: 99%

A Possible Role for Pioglitazone in the Management of Depressive Symptoms in Metabolic Syndrome Patients (EPICAMP Study): A Double Blind, Randomized Clinical Trial

Roohafza

Shokouh

Sadeghi

et al. 2014

International Scholarly Research Notices

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The present trial aimed to evaluate the effects of pioglitazone on the mental status of nondiabetic metabolic syndrome patients. From 145 patients screened, 104 eligible volunteers (57% female; age 20–70 years) were enrolled and randomly assigned to receive either pioglitazone (uptitrated to 30 mg/day; P = 53) or matching placebo (P = 51) for 24 weeks. Depression and anxiety were quantified using the hospital anxiety and depression scale and stress level using the general health questionnaire 12 at baseline, week 12, and endpoint. Homeostasis model assessment was used to estimate insulin resistance. At week 24, pioglitazone was superior in mitigating depression score (P = 0.011). In trend analysis, the effect of time (P < 0.001) and group (P = 0.023) as well as the time by group interaction (P = 0.032) on the mean depression score was considerable. In contrast, significant decrements in anxiety and stress levels (P < 0.001 and P = 0.012, resp.) were comparable between two groups. With respect to our findings, alterations in depression severity were not correlated with changes in insulin resistance level (P = 0.145). In conclusion, our findings suggest that pioglitazone might be able to improve mood in nondiabetic insulin resistant patients. (Registered at Australian New Zealand Clinical Trials Registry; ACTRN12611000351910.)

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“…(5) PRMT may be downregulated (reducing ADMA production) by reducing cholesterol concentration. (7) DDAH may be modified by reducing inhibitory influences (proton pump inhibitors,(37) smoking(5)), statins (38) or via upregulation by PPAR-γ (peroxisome proliferator-activated receptor γ) ligands (such as pioglitazone), (39) omega-3 fatty acids(40), and erythropoietin. (41) Interestingly, angiotensin-converting enzyme inhibitors may increase ADMA concentrations in hemodialysis patients via bradykinin signaling and may need discontinuation in select patients.…”

Section: Discussionmentioning

confidence: 99%

Serum Asymmetric and Symmetric Dimethylarginine and Morbidity and Mortality in Hemodialysis Patients

Shafi

Hostetter

Meyer

et al. 2017

American Journal of Kidney Diseases

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Background Asymmetric and symmetric dimethylarginines (ADMA and SDMA) are putative uremic toxins that may exert toxicity by a number of mechanisms including impaired nitric oxide synthesis and generation of reactive oxygen species. The study goal was to determine the association between these metabolites and cardiovascular outcomes in hemodialysis patients. Study Design Post hoc analysis of the Hemodialysis (HEMO) Study. Setting & Participants 1,276 prevalent hemodialysis patients with available samples 3–6 months after randomization. Predictor ADMA and SDMA measured in stored specimens. Outcomes Cardiac death, sudden cardiac death, first cardiovascular event, and any-cause death. Association with predictors analyzed using Cox regression adjusted for potential confounders (including demographics, clinical characteristics, comorbidities, albumin, and residual kidney function). Results Mean age of patients was 57 ±14 (SD) years, 63% were Black and 57% were female. Mean ADMA (0.9 ± 0.2 µM) and SDMA (4.3 ± 1.4 µM) were moderately correlated (r=0.418). Higher dialysis dose or longer session length were not associated with lower predialysis concentrations of ADMA or SDMA. In fully adjusted models, each doubling of ADMA was associated with higher risk (HR per 2-fold higher concentration; 95% CI) of cardiac death (1.83; 1.29–2.58), sudden cardiac death (1.79; 1.19–2.69), first cardiovascular event (1.50; 1.20–1.87), and any-cause death (1.44; 1.13–1.83). Compared to the lowest ADMA quintile (≤0.745 µM), the highest ADMA quintile (≥1.07 µM) was associated with higher risk (HR; 95% CI) of cardiac death (2.10; 1.44–3.05), sudden cardiac death (2.06; 1.46–2.90), first cardiovascular event (1.75; 1.35–2.27), and any-cause death (1.56; 1.21–2.00). SDMA was associated with higher risk of cardiac death (1.40; 1.03–1.92) but this was no longer statistically significant after adjusting for ADMA (1.20; 0.86–1.68). Limitations Single time-point measurement of ADMA and SDMA. Conclusions ADMA and, to a lesser extent SDMA are associated with cardiovascular outcomes in hemodialysis patients.

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Effects of Pioglitazone on Asymmetric Dimethylarginine and Components of the Metabolic Syndrome in Nondiabetic Patients (EPICAMP Study): A Double-Blind, Randomized Clinical Trial

Cited by 6 publications

References 44 publications

Effects of telmisartan and pioglitazone on high fructose induced metabolic syndrome in rats

Effects of telmisartan and pioglitazone on high fructose induced metabolic syndrome in rats

A Possible Role for Pioglitazone in the Management of Depressive Symptoms in Metabolic Syndrome Patients (EPICAMP Study): A Double Blind, Randomized Clinical Trial

Serum Asymmetric and Symmetric Dimethylarginine and Morbidity and Mortality in Hemodialysis Patients

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