Comprehensive Therapy

, Volume 28, Issue 4, pp 200–206

Effects of thiazolidinediones on cardiovascular risk factors

  • Biswanath P. Gouda
  • Sunil Asnani
  • Vivian A. Fonseca
Original Article

Abstract

The thiazolidinediones are the insulin sensitizers used in the management of Type 2 diabetes mellitus. These drugs can potentially decrease the risk of cardiovascular disease by correcting the different components of the insulin resistance syndrome.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Fonseca V. Rosenstock J. Patwardhan R. Salzman A. Effect of metformin and rosiglitazone combination therapy in patients with type 2 diabetes mellitus: A randomized controlled trial. JAMA. 2000;283:1695–1702.PubMedCrossRefGoogle Scholar
  2. 2.
    Miyazaki Y, Mahankal, A, Matsuda M, et al. Improved glycemic control and enhanced insulin sensitivity in type 2 diabetic subjects treated with pioglitazone. Diabetes Care. 2001;24:710–719.PubMedCrossRefGoogle Scholar
  3. 3.
    Lebovitz HE, Dole JF, Patwardhan R, Rappaport EB, Freed MI. The Rosiglitazone Clinical Trials Study Group. Rosiglitazone monotherapy is effective in patients with type 2 diabetes. J Clin Endocrinol Metabol. 2001;86:280–288.CrossRefGoogle Scholar
  4. 4.
    Phillips LS, Grunberger G, Miller E, Patwardhan R, Rappaport EB, Salzman A. The Rosiglitazone Clinical Trials Study Group. Once- and twice-daily dosing with rosiglitazone improves glycemic control in patients with type 2 diabetes. Diabetes Care. 2001;24:308–315.PubMedCrossRefGoogle Scholar
  5. 5.
    Auwerx J. PPARgamma: The ultimate thrifty gene. Diabetologia. 1999;42:1033–1049.PubMedCrossRefGoogle Scholar
  6. 6.
    Santomauro AT, Boden G, Silva ME, et al. Overnight lowering of FFAs with acipimox improves insulin resistance and glucose tolerance in obese diabetic and nondiabetic subjects. Diabetes. 1999;48:1836–1841.PubMedCrossRefGoogle Scholar
  7. 7.
    Hsueh WA, Law RE. Cardiovascular risk continuum: Implications of insulin resistance and diabetes. Am J Med. 1998;105(Suppl 1A):4S-14S.PubMedCrossRefGoogle Scholar
  8. 8.
    Davidson MB. Clinical implications of insulin resistance syndromes. Am J Med. 1995;99:420–426.PubMedCrossRefGoogle Scholar
  9. 9.
    National Institutes of Health. Detection, evaluation, and treatment of high blood cholesterol in adults (Adult treatment panel III).Google Scholar
  10. 10.
    Despres JP, Lamarche B, Mauriege P, et al. Hyperinsulinemia as an independent risk factor for ischemic heart disease. N Engl J Med. 1996;334:952–957.PubMedCrossRefGoogle Scholar
  11. 11.
    UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet. 1998;352:854–865.CrossRefGoogle Scholar
  12. 12.
    Rosenblatt S, Miskin B, Glazer NB, Prince MJ, Robertson KE. Pioglitazone 026 Study Group. The impact of pioglitazone on glycemic control and atherogenic dyslipidemia in patients with type 2 diabetes mellitus. Coron Artery Dis. 2001;12:413–423.PubMedCrossRefGoogle Scholar
  13. 13.
    Sunayama S, Watanabe Y, Ohmura H, et al. Effects of troglitazone on atherogenic lipoprotein phenotype in coronary patients with insulin resistance. Atherosclerosis. 1999;146:187–193.PubMedCrossRefGoogle Scholar
  14. 14.
    Raskin P, Rendell M, Riddle MC, Dole JF, Freed MI, Rosenstock J. The Rosiglitazone Clinical Trials Study Group. A randomized trial of rosiglitazone therapy in patients with inadequately controlled insulin-treated type 2 diabetes. Diabetes Care. 2001;24:1226–1232.PubMedCrossRefGoogle Scholar
  15. 15.
    Khan MA, St Peter JV, Xue JL. A prospective randomized comparison of the metabolic effects of pioglitazone or rosiglitazone in patients with type 2 diabetes who were previously treated with troglitazone. Diabetes Care. 2002;25:708–711.PubMedCrossRefGoogle Scholar
  16. 16.
    Friedlander Y, Kidron M, Caslake M, Lamb T, McConnell M, Bar-On H. Low density lipoprotein particle size and risk factors of insulin resistance syndrome. Atherosclerosis. 2000;148:141–149.PubMedCrossRefGoogle Scholar
  17. 17.
    Steinberg D, Parthasarathy S, Carew TE, et al. Beyond cholesterol: Modifications of low-density lipoprotein that Increase its atherogenicity. N Engl J Med. 1989;320:915–924.PubMedCrossRefGoogle Scholar
  18. 18.
    Cominacini L, Garbin U, Pastorino AM, et al. Increased susceptibility of LDL cholesterol to in vitro oxidation in patients with insulin-dependent and non-insulin dependent diabetes mellitus. Diabetes Res. 1994;26:173–184.PubMedGoogle Scholar
  19. 19.
    Nagy L, Tontonoz P, Alvarez JG, et al. Oxidized LDL regulates macrophage gene expression through ligand activation of PPARgamma. Cell. 1998;93:229–240.PubMedCrossRefGoogle Scholar
  20. 20.
    yamasaki Y, Kawamori R, Wasada T, et al. Pioglitazone (AD-4833) ameliorates insulin resistance in patients with NIDDM. Tohoku J Exp Med. 1997;183:173–183.PubMedCrossRefGoogle Scholar
  21. 21.
    Rosenstock J, Raskin P. Hypertension in diabetes mellitus. Cardiol Clin. 1988;6:547–560.PubMedGoogle Scholar
  22. 22.
    Scherbaum W, Burkhard G, for the German Pioglitazone Study Group. Pioglitazone reduces blood pressure in patients with type-2-diabetes mellitus [Abstract]. Diabetes. 2001;60 (Suppl 2):A462.Google Scholar
  23. 23.
    Bakst A, Schwartz S, Fischer JS, et al. Avandia worldwide awareness registry: Improved metabolic control with initiation of rosiglitazone in a diabetes clinic setting [Abstract]. Diabetes. 2001;50 (Suppl 2):A430.Google Scholar
  24. 24.
    Nolan JJ, Ludvik B, Beerdsen P, et al. Improvement in glucose tolerance and insulin resistance in obese subjects treated with troglitazone, N Engl J Med. 1994;331:1188–1193.PubMedCrossRefGoogle Scholar
  25. 25.
    Ogihara T, Rakugi H, Ikegami H, Mikami H, Masuo K. Enhancement of insulin sensitivity by troglitazone lowers blood pressure in diabetic hypertensives. Am J Hyperten. 1995;8:316–320.CrossRefGoogle Scholar
  26. 26.
    Kawasaki J, Hirano K, Kanaide H, et al. Mechanisms of vasorelaxation induced by troglitazone: A novel antidiabetic drug, in the porcine coronary artery. Circulation. 1998;98:2446–2252.PubMedGoogle Scholar
  27. 27.
    Song J, Walsh MF, Sowers JR, et al. Troglitazone reduces contraction by inhibition of vascular smooth muscle cell calcium currents and not endothelial nitric oxide production. Diabetes. 1997;6:659–664.CrossRefGoogle Scholar
  28. 28.
    Gaenzer H, Neumayr G, Marschang P, et al. Effect of insulin therapy on endothelium-dependent dilation in type 2 diabetes mellitus. Am J Cardiol. 2002;89:431–434.PubMedCrossRefGoogle Scholar
  29. 29.
    Steinberg HO, Chaker H, Leaming R. Obesity/insulin resistance is associated with endothelial dysfunction: Implications for the syndrome of insulin resistance. J Clin Invest. 1996;97:2601–2610.PubMedCrossRefGoogle Scholar
  30. 30.
    Anand MM, Fonseca VA. Endothelial dysfunction and type 2 diabetes. Pract Diabetol. 1999;18:23–27.Google Scholar
  31. 31.
    Lehmann ED, Riley WA, Clarkson P, et al. Non-invasive assessment of cardiovascular disease in diabetes mellitus. Lancet. 1997;350(Suppl 1):14–19.CrossRefGoogle Scholar
  32. 32.
    Avena R, Mitchell ME, Sidawy AN. Insulin action enhancement normalizes brachial artery vasoactivity in patients with peripheral vascular disease and occult diabetes. J Vasc Surg. 1998;28:1024–1031.PubMedCrossRefGoogle Scholar
  33. 33.
    Tack CJ, Ong MK, Lutterman JA, et al. Insulin-induced vasodilatation and endothelial function in obesity/insulin resistance: Effects of troglitazone. Diabetologia. 1998;41:569–576.PubMedCrossRefGoogle Scholar
  34. 34.
    Murakami T, Mizuno S, Ohnaka M. Troglitazone restores endothelium-dependent vasomotion of resistance coronary artery [Abstract]. Circulation. 1998;98(Suppl):I-111A.Google Scholar
  35. 35.
    Mohanty P, Aljada A, Ghanim H, et al. Rosiglitazone improves vascular reactivity, inhibits reactive oxygen species (ROS) generation, reduces P47phox subunit expression in mononuclear cells (MNC) and reduces C reactive protein (CRP) and monocyte chemotatic protein-1 (MCP-1): Evidence of a potent anti-inflammatory effect [Abstract]. Diabetes. 2001;50(Suppl 2):A68.Google Scholar
  36. 36.
    Stuhlinger MC, Abbasi F, Chu JW, et al. Relationship between insulin resistance and an endogenous nitric oxide synthase inhibitor. JAMA. 2002;287:1420–1426.PubMedCrossRefGoogle Scholar
  37. 37.
    Minamikawa J, Tanaka S, Yamauchi M, et al. Potent inhibitory effect of troglitazone on carotid arterial wall thickness in type 2 diabetes. J Clin Endocrinol Metab. 1998;83:1818–1820.PubMedCrossRefGoogle Scholar
  38. 38.
    Koshiyama H, Shimono D, Kuwamura N, et al. Rapid communication: Inhibitory effect of pioglitazone on carotid arterial wall thickness in type 2 diabetes. J Clin Endocrinol Metab. 2001;86:3452–3456.PubMedCrossRefGoogle Scholar
  39. 39.
    Huber K, Christ G, Wojta J, Gulba D. Plasminogen activator inhibitor type-1 in cardiovascular disease: Status report 2001. Thromb Res. 2001;103(Suppl 1):S7-S19.PubMedCrossRefGoogle Scholar
  40. 40.
    Jokl R, Colwell JA. Arterial thrombosis and atherosclerosis in diabetes. Diabet Rev. 1997;5:316.Google Scholar
  41. 41.
    Melidonis A, Stefanidis A, Tournis S, et al. The role of strict metabolic control by insulin infusion on fibrinolytic profile during an acute coronary event in diabetic patients. Clin Cardiol. 2000;23:160–164.PubMedCrossRefGoogle Scholar
  42. 42.
    Sobel BE. Coronary artery disease and fibrinolysis: From the blood to the vessel wall. Thromb Haemost. 1999;82(Suppl):8–13.PubMedGoogle Scholar
  43. 43.
    Ehrmann DA, Schneider DJ, Sobel BE, et al. Troglitazone improves defects in insulin action, insulin secretion, ovarian steroidogenesis, and fibrinolysis in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 1997;82:2108–2116.PubMedCrossRefGoogle Scholar
  44. 44.
    Fonseca VA, Reynolds T, Hemphil D, et al. Effect of troglitazone on fibrinolysis and activated coagulation in patients with non-insulin-dependent diabetes mellitus. J Diabetes Complications. 1998;12:181–186.PubMedCrossRefGoogle Scholar
  45. 45.
    McTernan PG, Eggo MC, Smith SA, et al. Rosiglitazone inhibits the insulin-mediated increase in PAI-1 secretion in human subcutaneous adipocytes [Abstract]. Diabetes. 2001;50(Suppl 2):A275.Google Scholar
  46. 46.
    Fuell DL, Freed MI, Greenberg AS, et al. The effect of treatment with rosiglitazone on C-reactive protein and interleukin-6 in patients with type 2 diabetes [Abstract]. Diabetes. 2001;50 (Suppl 2):A435.Google Scholar
  47. 47.
    Mattock MB, Morrish NJ, Viberti GC, et al. Prospective study of microalbuminuria as a predictor of mortality in NIDDM. Diabetes. 1992;41:736–741.PubMedCrossRefGoogle Scholar
  48. 48.
    Solerte SB, Rondanelli M, Giacchero R, et al. Serum glucagons concentration and hyperinsulinaemia influence renal haemodynamics and urinary protein loss in normotensive patients with central obesity. Int J Obesity Relat Metabol Dis. 1999;23:997–1003.CrossRefGoogle Scholar
  49. 49.
    Fujii M, Takemura R, Yamaguchi M. Troglitazone (CS-045) ameliorates albuminuria in streptozotocin-induced diabetic rats. Metabolism. 1997;46:981–983.PubMedCrossRefGoogle Scholar
  50. 50.
    Imano E, Kanda T, Nakatani Y, et al. Effect of troglitazone on microalbuminuria in patients with incipient diabetic nephropathy. Diabetes Care. 1998;21:2135–2139.PubMedCrossRefGoogle Scholar
  51. 51.
    Bakris G, Weston WM, Rappaport EB, et al. Rosiglitazone produces long-term reductions in urinary albumin excretion in type 2 diabetes [Abstract]. Diabetologia. 1999;42(Suppl 1):230A.Google Scholar
  52. 52.
    Lebovitz HE, Dole JF, Patwardhan R, et al. Rosiglitazone monotherapy is effective in patients with type 2 diabetes. J Clin Endocrinol Metab. 2001;86:280–288.PubMedCrossRefGoogle Scholar
  53. 53.
    Nakamura T, Ushiyama T, Shimada N, et al. Comparative effects of pioglitazone, glibencamide, and volgibose on urinary endothelin-1 and albumin excretion in diabetes patients. J Diabetes Complications. 2000;14:250–254.PubMedCrossRefGoogle Scholar
  54. 54.
    de Souza CJ, Eckhardt M, Gagen K, et al. Effects of pioglitazone on adipose tissue remodeling within the setting of obesity and insulin resistance. Diabetes. 2001;50:1863–71.PubMedCrossRefGoogle Scholar
  55. 55.
    Kelly IE, Han TS, Walsh K, et al. Effects of a thiazolidinedione compound on body fat and fat distribution of patients with type 2 diabetes. Diabetes Care. 1999;22:288–293.PubMedCrossRefGoogle Scholar
  56. 56.
    Miyazaki Y, Mahankali A, Matsuda M, et al. Effect of pioglitazone on abdominal fat distribution and insulin sensitivity in patients with type 2 diabetes mellitus (T2DM) [Abstract]. Diabetes. 2000;49(Suppl 1):A299.Google Scholar
  57. 57.
    Yamamoto K, Ohki R, Lee RT, Ikeda U, Shimada K. Peroxisome proliferator-activated receptor gamma activators inhibit cardiac hypertrophy in cardiac myocytes. Circulation. 2001;104:1670–1675.PubMedGoogle Scholar
  58. 58.
    Ghazzi MN, Perez JE, Antonucci TK, et al. Cardiac and glycemic benefits of troglitazone treatment in NIDDM. The Troglitazone Study Group. Diabetes. 1997;46:433–439.PubMedCrossRefGoogle Scholar
  59. 59.
    Sutton MS, Dole JF, Rappaport EB. Rosiglitazone does not adversely affect cardiac structure of function in patients with type 2 diabetes [Abstract]. Diabetes 1999;49(Suppl):A102.Google Scholar
  60. 60.
    Rubin CJ, Shaffer S, Pioglitazone 001 Study Group. Echocar-diographic assessment in patients with type 2 diabetes mellitus treated with pioglitazone [Abstract]. Diabetes. 2000;49(Suppl):A364.Google Scholar

Copyright information

© Humana Press Inc. 2002

Authors and Affiliations

  • Biswanath P. Gouda
    • 1
  • Sunil Asnani
    • 1
  • Vivian A. Fonseca
    • 1
  1. 1.Tulane Diabetes Program, Department of Medicine, Section of EndocrinologyTulane University Medical Center, SL-53New OrleansUSA

Personalised recommendations