Pioglitazone Increases Serum Magnesium Levels in Glucose-Intolerant Subjects. A Randomized, Controlled Trial

Abstract

Although thiazolidinediones and magnesium supplementation improves insulin action and increases HDL-cholesterol, the potential link between serum magnesium and thiazolidinediones has received little attention. Focusing on the increase of serum magnesium, 63 eligible subjects were enrolled and randomly allocated to receive either 30 mg Pioglitazone once daily (Group A) or lifestyle intervention (Group B) during 12 weeks. Subjects were eligible if they were glucose-intolerant, and excluded if they had high blood pressure, diabetes or abnormal liver function tests. The personnel assessing outcomes were blinded to group assignment. Of the 63 eligible subjects, 3 dropped out (one in group A, and two in Group B) because they moved out of the city. So, 30 subjects in each group, who satisfactorily completed the follow-up, were included in the analysis of data. There were no serious adverse events or side effects due to Pioglitazone or lifestyle intervention. At baseline, the groups did not differ significantly in serum magnesium levels 1.73 +/- 0.17 versus 1.72 +/- 0.14 mg/dl, p = 0.80. Subjects who received Pioglitazone significantly increased their serum magnesium to 1.93 +/- 0.16 mg/dl whereas in the lifestyle intervention group the increase was 1.74 +/- 0.25 mg/dl, p < 0.0001. What this study showed was a significant increase in the serum magnesium levels of glucose-intolerant subjects who received 30 mg Pioglitazone once daily.

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

“…Our study, the largest so far in terms of the sample size, in line with three other trials [10, 12, 36] has found pioglitazone to have a significant increasing effect on serum HDL-C but not on triglycerides. In contrast, others [37–39] have failed to observe any considerable change in lipid profile of nondiabetic participants after 12–16 weeks of pioglitazone administration. While these results await future confirmation, the null effect of pioglitazone on total cholesterol and LDL-C in our study seems undisputed as no contradictory reports have been found.…”

Effect of Opuntia humifusa Supplementation and Acute Exercise on Insulin Sensitivity and Associations with PPAR-γ and PGC-1α Protein Expression in Skeletal Muscle of Rats

“…Although exact correlation between PPARs and Mg 2+ is not clearly understood, an interaction between Mg 2+ and PPAR-γ receptor has been suggested. A previous study showed that 12 weeks of pioglitazone treatment (30 mg/day), which is a prescription drug of the TZDs class with a high binding affinity for PPAR-γ [31], increased serum Mg 2+ level by 112% [32,33]. According to a previous study, PPAR-γ protein is expressed at low level in muscle, but PPAR-γ protein is an important role for regulation GLUT-4 gene expression in muscle tissue [23].…”

Effects of Pioglitazone on Lipoproteins, Inflammatory Markers, and Adipokines in Nondiabetic Patients with Metabolic Syndrome

“…In the multicenter 28-week GLAI study of 735 patients, 45 mg of PIO raised HDL-C by 14.9% compared with a 7.8% increase by 8 mg of ROSI (PϽ0.001). In nondiabetic populations, data suggest that PIO does not significantly affect HDL-C; 19,20 however, 1 study of PIO in nondiabetic patients with hypertension reported a significant HDL-C increase of 8%. 9 This general lack of reported effect could be explained by small samples sizes and a lack of selection of patients with low HDL-C. Our HDL-C findings are comparable to the increases in HDL-C seen in response to fibrates but higher than produced with statin drugs.…”