UMR 866 INSERM-UB, Team Physiopathology of dyslipidemias, Faculty of Sciences Gabriel, University of Burgundy, Dijon 21000, France.
Diabetes Metab Res Rev. 2010 May;26(4):297-305. doi: 10.1002/dmrr.1081.
Pioglitazone (PIO) and rosiglitazone (ROSI) are widely used as oral antidiabetic agents for treatment of type 2 diabetes. Although these medications exert similar effects on blood glucose, recent clinical studies indicated that PIO has a more pronounced beneficial effect on lipid parameters than ROSI. In order to get further insight into the lipid effects of both drugs, we tested whether PIO, compared to ROSI, could exert direct effects on lipid liver metabolism in relation with plasma lipids.
We performed in vitro studies using mice liver slices incubated 21 h either with ROSI (1 micromol/L) or PIO (7.5 micromol/L).
We showed that both glitazones slightly reduced HMG-CoA reductase mRNA levels at the same degree but only PIO reduced intracellular cholesterol content, suggesting an alteration of cholesterol uptake rather than an inhibition of cholesterol biosynthesis. This concept was supported by the reduction of scavenger receptor class B type I expression, hepatic lipase activity and high-density lipoprotein cholesterol uptake in PIO-treated liver explants. Conversely, hepatic lipase mRNA levels were increased 3.5-fold. ROSI, but not PIO, induced acetyl-CoA carboxylase and fatty acid synthase gene expression and increased apoB secretion suggesting a stimulation of lipogenesis. Concurrently, peroxisome proliferator-activated receptor-gamma mRNA levels were induced by ROSI and not significantly changed by PIO. Besides, PIO appeared to be a more potent activator of AMP-Activated Protein Kinase than ROSI.
PIO and ROSI exert specific direct effects on liver and extrapolating these data to humans could explain the significant improvements in plasma lipids observed in diabetic patients treated with PIO.
吡格列酮(PIO)和罗格列酮(ROSI)被广泛用作治疗 2 型糖尿病的口服降糖药物。尽管这些药物对血糖有相似的作用,但最近的临床研究表明,PIO 对血脂参数的有益影响比 ROSI 更为显著。为了更深入地了解这两种药物的脂质作用,我们测试了 PIO 是否与 ROSI 相比,能对与血浆脂质有关的脂质肝脏代谢产生直接影响。
我们使用培养 21 小时的小鼠肝切片进行体外研究,用 ROSI(1 微摩尔/升)或 PIO(7.5 微摩尔/升)孵育。
我们表明,两种格列酮都能在相同程度上轻微降低 HMG-CoA 还原酶 mRNA 水平,但只有 PIO 降低细胞内胆固醇含量,提示胆固醇摄取的改变,而不是胆固醇生物合成的抑制。这一概念得到了 PIO 处理的肝组织中清道夫受体 B 型 I 表达、肝脂肪酶活性和高密度脂蛋白胆固醇摄取减少的支持。相反,肝脂肪酶 mRNA 水平增加了 3.5 倍。ROSI 而不是 PIO 诱导乙酰辅酶 A 羧化酶和脂肪酸合酶基因表达,并增加载脂蛋白 B 的分泌,提示脂肪生成的刺激。同时,ROSI 诱导过氧化物酶体增殖物激活受体-γ mRNA 水平,而 PIO 则无明显变化。此外,PIO 似乎比 ROSI 更能激活 AMP 激活的蛋白激酶。
PIO 和 ROSI 对肝脏有特定的直接作用,将这些数据外推到人类身上,可以解释在接受 PIO 治疗的糖尿病患者中观察到的血浆脂质的显著改善。