Lin K-D, Lee M-Y, Feng C-C, Chen B K, Yu M-L, Shin S-J
The Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Columbia, SC, USA; Division of Endocrinology and Metabolism, Columbia, SC, USA.
Diabet Med. 2014 Nov;31(11):1341-9. doi: 10.1111/dme.12481. Epub 2014 May 30.
To investigate the recovery of thiazolidinedione-induced body weight gain and haematopoietic changes after stopping pioglitazone treatment in patients with Type 2 diabetes.
This retrospective cohort study included 214 patients divided into three groups according to pioglitazone treatment status. The first study arm included patients who received pioglitazone for 38 months then interrupted this for 10 months (pioglitazone-interruption group). The second arm consisted of patients who received pioglitazone throughout the 48 months (pioglitazone-continuous group); the third arm included patients who had never received pioglitazone therapy (control group).
Red blood cell count and haematocrit and haemoglobin levels decreased significantly, while body weight increased in the two pioglitazone-treated groups as compared with the control group at 38 months. Multivariate regression analysis showed that the reductions in red blood cell count/haemoglobin levels were associated with pioglitazone use. In the pioglitazone-interruption group, no recoveries of red blood cells, or haematocrit or haemoglobin levels were observed after stopping pioglitazone for 10 months compared with the pioglitazone-continuous group, but body weight gain decreased to a level that was significantly lower than that in the pioglitazone-continuous group and did not differ significantly from the control group.
In this study, we observed a reversal of body weight gain but no recoveries in red blood cells or haematocrit or haemoglobin levels after stopping pioglitazone for 10 months in patients treated with pioglitazone for 38 months. This finding should prompt a reconsideration of the sustained effect of thiazolidinediones on the haematopoietic system in patients with Type 2 diabetes.
研究2型糖尿病患者停用吡格列酮治疗后，噻唑烷二酮类药物所致体重增加及造血变化的恢复情况。
这项回顾性队列研究纳入了214例患者，根据吡格列酮治疗状态分为三组。第一个研究组包括接受吡格列酮治疗38个月后中断治疗10个月的患者（吡格列酮中断组）。第二组由在整个48个月期间均接受吡格列酮治疗的患者组成（吡格列酮持续组）；第三组包括从未接受过吡格列酮治疗的患者（对照组）。
在38个月时，与对照组相比，两个吡格列酮治疗组的红细胞计数、血细胞比容和血红蛋白水平显著降低，而体重增加。多变量回归分析显示，红细胞计数/血红蛋白水平的降低与吡格列酮的使用有关。在吡格列酮中断组中，与吡格列酮持续组相比，停用吡格列酮10个月后未观察到红细胞、血细胞比容或血红蛋白水平的恢复，但体重增加降至显著低于吡格列酮持续组的水平，且与对照组无显著差异。
在本研究中，我们观察到接受吡格列酮治疗38个月的患者停用吡格列酮10个月后，体重增加出现逆转，但红细胞、血细胞比容或血红蛋白水平未恢复。这一发现应促使重新考虑噻唑烷二酮类药物对2型糖尿病患者造血系统的持续影响。
