Rosiglitazone and pioglitazone similarly improve insulin sensitivity and secretion, glucose tolerance and adipocytokines in type 2 diabetic patients.

OBJECTIVE

We examined the effects of rosiglitazone treatment on profiles of adipocytokines levels, postprandial insulin and glucose excursion, lipids levels, comparing with those of pioglitazone treatment in patients with type 2 diabetes mellitus (T2DM).

METHODS

Changes in body weight, haemoglobin A(1c )(HbA(1c)), glucose/insulin/C-peptide/free fatty acid (FFA) during 75 g oral glucose tolerance test (OGTT), HDL-/LDL-cholesterol, triglyceride (TG) and adipocytokines [tumour necrosis factor (TNF)-alpha, leptin and adiponectin] were measured in T2DM patients treated with rosiglitazone, 8 mg/day (n = 35), or pioglitazone, 45 mg/day (n = 21), for 3 months.

RESULTS

After rosiglitazone or pioglitazone treatment, HbA(1c )(8.6-7.2 vs. 8.3-6.9%, rosiglitazone vs. pioglitazone), fasting plasma glucose (190-144 vs. 178-140 mg/dl), fasting FFA (729-595 vs. 641-526 microEq/l), mean plasma glucose-OGTT (292-229 vs. 285-233 mg/dl) and mean FFA-OGTT (580-430 vs. 488-377 microEq/l) decreased similarly and all were statistically significant (p < 0.01). The insulinogenic index (DeltaI(0-120)/DeltaG(0-120)) (0.19-0.30 vs. 0.17-0.26) and Matsuda index of insulin sensitivity (2.0-3.1 and 2.7-4.3) increased (p < 0.01) similarly, despite increase in body weight (85-88 vs. 81-84 kg). TNF-alpha (3.8-3.4 vs. 5.2-4.5 pg/ml) decreased (p < 0.05) and adiponectin (6.3-17.8 vs. 7.1-16.4 microg/ml) increased (p < 0.01), while leptin did not change following either treatment. After rosiglitazone treatment, plasma HDL-cholesterol (34-38 mg/dl) and LDL-cholesterol (103-120 mg/dl) increased (p < 0.01), while TGs (177-167 mg/dl) did not change significantly. After pioglitazone treatment, plasma HDL-cholesterol (34-37 mg/dl) increased (p < 0.05), while LDL-cholesterol (104-105 mg/dl) did not change and TGs (153-106 mg/dl) decreased (p < 0.01).

CONCLUSIONS

Rosiglitazone and pioglitazone have similar beneficial effects on glycaemic control insulin sensitivity, insulin secretion and plasma adipocytokine levels. However, pioglitazone has a more beneficial effect on the plasma lipid profile than rosiglitazone.