Treatment with combination of pioglitazone and glimepiride decreases levels of chemerin and asymmetric dimethylarginine (ADMA) in obese type 2 diabetic patients

  • Ahmed A. Youssef
  • Eman T. MehannaEmail author
  • Omnia I. Ezzat
  • Dina M. Abo-Elmatty
  • Hussein Al-Sawaf
Original Article


Chemerin is an adipokine that plays a crucial role in adipocyte differentiation and development, as well as in glucose and lipid metabolism. High levels of asymmetric dimethylarginine (ADMA), a naturally occurring product of metabolism, inhibit nitric oxide (NO) synthesis and are related to endothelial dysfunction. The aim of this study was to investigate the effect of vildagliptin therapy and the combination of pioglitazone and glimepiride on the levels of NO, ADMA, and chemerin in diabetic patients. The study was conducted on 140 subjects, including 40 apparently healthy subjects, and 100 type 2 diabetic obese patients; 50 of them were treated with vildagliptin, and the other 50 patients revived combination of pioglitazone and glimepiride, both groups were treated for 12 months. For all participants, the levels of fasting blood glucose (FBG), fructosamine, HbA1c, lipid profile, ADMA, NO, and chemerin were determined. The levels of those parameters were compared before and after treatment. In both treated groups, levels of FBG, fructosamine, HbA1c, TC, and LDL-C decreased after treatment. Levels of chemerin and ADMA decreased significantly after treatment, whereas the levels of NO increased compared to the baseline values. Additionally, levels of chemerin and ADMA in the group treated with combination of pioglitazone and glimepiride were significantly lower compared to the group treated with vildagliptin. In conclusion, treatment with combination of pioglitazone and glimepiride had a favorable effect on chemerin and ADMA levels in obese type 2 diabetic patients.


Asymmetric dimethylarginine Chemerin Nitric oxide Obesity Type 2 diabetes mellitus 



Asymmetric dimethylarginine


Body mass index


Fasting blood glucose


Glycated hemoglobin


High-density lipoprotein cholesterol


Low-density lipoprotein cholesterol


Nitric oxide


Nitric oxide synthase


Proliferator-activated receptor gamma


Type 2 diabetes mellitus




Total cholesterol





The authors are thankful to the staff members of the outpatients’ clinic of diabetes in Suez Hospitals for their help in collection of samples.

Authors’ contributions

All authors have contributed significantly to the study. Dina M. Abo-Elmatty and Hussein Al-Sawaf designed the study. Ahmed A. Youssef and Omnia I Ezzat were responsible for collection of samples and laboratory work. Eman T. Mehanna was responsible for data analysis. Ahmed A. Youssef and Eman T. Mehanna wrote the manuscript. This work was funded by the authors.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

The present study was conducted according to the principles of the Declaration of Helsinki. The study protocol was approved by the Suez Canal University Research Ethics Committee (code # 201611MH2).

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Research Society for Study of Diabetes in India 2018

Authors and Affiliations

  1. 1.Department of Biochemistry, Faculty of PharmacyEgyptian Russian UniversityCairoEgypt
  2. 2.Department of Biochemistry, Faculty of PharmacySuez Canal UniversityIsmailiaEgypt

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