Risk management in the treatment of type 2 diabetes with pioglitazone

Figures & data

Figure 1 Pioglitazone chemical structure.

Table 1 Pioglitazone effects on lipoproteins

Site	Effects
Blood	↓Tg
	↓FFA
	↓Lipid perox
	↓TNF-α
	↓Resistin
	↓sdLDL
	↑HDL-C
	↑LDL 1, HDL 2
Adipose tissue	↑Transport proteins of FFA
Liver	↓ApoCIII
	↑ApoAI

Abbreviations: Tg, triglycerides; ApoCIII, apolipoprotein CIII; FFA, free fatty acids; ApoAI, apolipoprotein AI; sdLDL, small-dense LDL; HDL-C, high-density lipoprotein cholesterol; LDL, low-density lipoprotein.

Table 2 Thiazolidinediones and lipid profile: experience of the authors

Treatment	Results		Conclusions
Pioglitazone + glimepiride	HbA1c	−1.3%**	Pioglitazone in association with glimepiride provided a significant improvement of lipid profile components; no changes were obtained for the same parameters with rosiglitazone (Derosa et al)^Citation27
	TC	−3.76%*,†
	LDL	−10.6%*,†
	HDL	+9.5%*,†
	Tg	−19.3%*,†
	apoAI	+2.3%*
	apoB	−9.0%*,†

* p < 0.05 vs baseline;

** p < 0.01 vs baseline;

† p < 0.05 vs the comparative treatment.

Abbreviations: HbA_1c, glycosylated hemoglobin; TC, total cholesterol; LDL-C, low-density lipoprotein; HDL-C, high-density lipoprotein; Tg, triglycerides; apoAI, apolipoprotein AI; apolipoprotein B.

Table 3 Thiazolidinediones and non-conventional cardiovascular risk factors: experience of the authors

Treatment	Results		Conclusions
Pioglitazone + metformin	HbA1c	−1.0%**	Pioglitazone in association with metformin provided a significant improvement in Lp(a) concentration (Derosa et al)^Citation38
	TC	−6.4%*,†
	LDL	−5.2%*,†
	HDL	+4.34%*,†
	Tg	−19.2%*,†
	Lp (a)	−10.4%*,†
	HCT	−17.3%*
Pioglitazone + glimepiride	HbA1c	−1.1%**	Combination treatment produced a slight but significant reduction of PAI-I concentration (Derosa et al)^Citation30
	Tg	−19.0%*,†
	PAI-I	−18.0%*
	t-PA	−16.8%
	Fg	−3.6%

* p < 0.05 vs baseline;

** p < 0.01 vs baseline;

† p < 0.05 vs the comparative treatment.

Abbreviations: HbA_1c, glycosylated hemoglobin; TC, total cholesterol; LDL-C, low-density lipoprotein; HDL-C, high-density lipoprotein; Tg, triglycerides; Lp(a), lipoprotein(a); HCT, homocysteine; PAI-1, plasminogen activator inhibitor 1; t-PA, tissue-plasminogen activator; Fg, fibrinogen.

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