Two-hour postload plasma glucose and pigment epithelium-derived factor levels are markers of coronary artery inflammation in type 2 diabetic patients
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We have previously found that pioglitazone attenuates inflammation in the left main trunk of coronary artery (LMT), evaluated as target-to-background ratio (TBR) by 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in patients with impaired glucose tolerance or type 2 diabetes.
We assessed which clinical variables could predict the change in TBR in the LMT after 4-month add-on therapy with oral hypoglycemic agents (OHAs).
A total of 38 type 2 diabetic patients with carotid atherosclerosis who had already received OHAs except for pioglitazone was enrolled. At baseline and 4 months after add-on therapy with pioglitazone or glimepiride, all patients underwent 75 g oral glucose tolerance test, blood chemistry analysis, and FDG-PET/CT.
Fasting plasma glucose, 30-, 60-, 90-, 120-minutes postload plasma glucose, HbA1c, and LMT-TBR values were significantly decreased by add-on therapy, whereas high-density lipoprotein-cholesterol and adiponectin levels were increased. Increased serum levels of pigment epithelium-derived factor (PEDF), a marker of insulin resistance and non-use of aspirin at baseline could predict the favorable response of LMT-TBR to add-on therapy. Moreover, Δ120-minutes postload plasma glucose and ΔPEDF were independent correlates of ΔLMT-TBR.
Our present study suggests that 120-minutes postload plasma glucose and PEDF values may be markers and potential therapeutic targets of coronary artery inflammation in type 2 diabetic patients.
Clinical Trial Registration
URL: http://clinicaltrials.gov. Unique identifier: NCT00722631.
KeywordsCoronary artery inflammation FDG-PET insulin resistance 75 g OGTT PEDF
Positron emission tomography
- 75 g OGTT
75 g oral glucose tolerance test
Oral hypoglycemic agents
Pigment epithelium-derived factor
Left main trunk of coronary artery
TBR in the LMT
We thank Mami Nakayama, Miho Nakao-Kogure, Katsue Shiramizu, Miyuki Nishikata, Yuri Nishino, Makiko Kiyohiro (Kurume University), and Kouichi Nitta (Hitachi Ltd., Tokyo, Japan) for their technical assistance.
This study was supported in part by research grants from the Kimura Memorial Foundation (to YN, MB, AT, SM, AH and TN), the Grant-in-Aid for Scientific Research C (17K09564 and 17K08968) from the Japan Society for the Promotion of Science (JSPS KAKENHI), Tokyo, Japan (to NT and SY). Yoichi Sugiyama, Sachiyo Igata, Jiahui Sun, Seiji Kurata, Kiminori Fujimoto, Toshi Abe, Takanori Matsui, and Yoshihiro Fukumoto have nothing to disclose.
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