The effects of rosiglitazone and metformin on inflammation and endothelial dysfunction in patients with type 2 diabetes mellitus

Diabetic patients have a markedly increased risk of cardiovascular disease compared with non-diabetics. Two drug groups today target insulin resistance; biguanides and thiazolidinediones. In addition, these may have other effects on cardiovascular risk factors. The aim of this study was to evaluate...

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Bibliographic Details
Published in:Acta diabetologica 2011-12, Vol.48 (4), p.297-302
Main Authors: Fidan, Evren, Onder Ersoz, H., Yilmaz, Mustafa, Yilmaz, Hulya, Kocak, Mustafa, Karahan, Caner, Erem, Cihangir
Format: Article
Language:English
Subjects:
Adult
C-Peptide - immunology
Cardiovascular disease
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - etiology
Cardiovascular Diseases - immunology
Cardiovascular Diseases - physiopathology
Diabetes
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - drug therapy
Diabetes Mellitus, Type 2 - metabolism
Drug therapy
Endothelial Cells - drug effects
Endothelial Cells - immunology
Endothelium
Female
Humans
Interleukin-6 - immunology
Internal Medicine
Male
Medicine
Medicine & Public Health
Metabolic Diseases
Metformin - therapeutic use
Middle Aged
Original Article
Patients
Thiazolidinediones - therapeutic use
Tumor Necrosis Factor-alpha - immunology
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Summary:Diabetic patients have a markedly increased risk of cardiovascular disease compared with non-diabetics. Two drug groups today target insulin resistance; biguanides and thiazolidinediones. In addition, these may have other effects on cardiovascular risk factors. The aim of this study was to evaluate the effects of metformin and rosiglitazone on non-traditional cardiovascular risk factors. Forty type 2 diabetic patients were randomized into metformin and rosiglitazone groups. After receiving the optimal doses, the patients were monitored for 12 weeks. Biochemical parameters, lipid parameters, CRP, insulin, c-peptide, and HbA1c levels were analyzed. VWF, PAI-1, ICAM-1, TNF-α, IL-6, E-selectin, and fibrinogen levels were measured in order to assess coagulation status and endothelial dysfunction. In the metformin group, body mass index, PPG, HbA1c, IL-6, ICAM-1, and TNF-α levels were significantly decreased after 12 weeks compared with the basal levels. IL-6 levels decreased from 75 pg/ml ± 20 to 42 pg/ml ± 9 ( P 0.023) and TNF- α levels from 61 pg/ml ± 31 to 39 pg/ml ± 10 ( P 0.018). In the rosiglitazone group, FPG, PPG, HbA1c, insulin, HOMA-IR, IL-6, and TNF-α levels decreased significantly after 12 weeks compared with the basal levels. IL-6 levels decreased from 78 pg/ml ± 21 to 41 pg/ml ± 9 ( P 0.028) and TNF-α levels from 62 pg/ml ± 19 to 37 pg/ml ± 10 ( P 0.012). At the end of the study, no significant differences were determined between groups. Insulin resistance and type 2 diabetes are strongly associated with low grade inflammation. Both metformin and rosiglitazone were effective in controlling inflammatory markers in addition to metabolic parameters.
ISSN:0940-5429
1432-5233
DOI:10.1007/s00592-011-0276-y