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Effect of pioglitazone on systemic inflammation is independent of metabolic control and cardiac autonomic function in patients with type 2 diabetes

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Abstract

The aim of this article is to investigate the relation of the anti-inflammatory effect of pioglitazone with cardiac autonomic function and metabolic control in diabetic patients. In this prospective open label trial, 36 type 2 diabetic patients (age 60 ± 10, 20 M) without overt cardiovascular disease were randomized to add pioglitazone (30 mg) to their therapy or to continue standard therapy. C-reactive protein (CRP) serum levels, metabolic parameters and cardiac autonomic function (assessed by heart rate variability [HRV] on 24-h ECG Holter monitoring) were measured at baseline and after 3 months. Clinical and laboratory variables were similar in the two groups. No significant changes were observed after 3 months for metabolic and anthropometric parameters, except for a mild increase in HDL levels in the pioglitazone group only (P = 0.04 vs. controls). CRP levels decreased significantly at follow-up in the pioglitazone group (3.2 ± 1.97 vs. 2.37 ± 1.56 mg/l) but not in the control group (3.0 ± 1.92 vs. 3.93 ± 2.14 mg/l; P = 0.003). No differences were found in basal and follow-up HRV variables between the two groups. In type 2 diabetic patients pioglitazone exerts favourable effects on inflammation even after short-term therapy. This effect precedes those on metabolic and anthropometric parameters and is not associated with changes in cardiac autonomic function.

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Abbreviations

CRP:

C-reactive protein

FPG:

Fasting plasma glucose

HRV:

Heart rate variability

LF:

Low frequency amplitude

HF:

High frequency amplitude

PPAR:

Peroxisome proliferator-activated receptors

SDNN:

Standard deviation of NN intervals

SDNNi:

Mean of the standard deviations of NN intervals of all 5 min segments in the recording

VLF:

Very low frequency amplitude

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Competing interest

None to declare.

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Authors and Affiliations

  1. Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy

    Roberto Nerla, Giancarla Scalone, Ilaria Coviello, Roberto Mollo, Gaetano A. Lanza & Filippo Crea

  2. Servizio di Diabetologia, Università Cattolica del Sacro Cuore, Rome, Italy

    Dario Pitocco, Francesco Zaccardi & Giovanni Ghirlanda

Authors
  1. Roberto Nerla
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  2. Dario Pitocco
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  3. Francesco Zaccardi
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  4. Giancarla Scalone
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  5. Ilaria Coviello
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  6. Roberto Mollo
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  7. Giovanni Ghirlanda
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  8. Gaetano A. Lanza
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  9. Filippo Crea
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Corresponding author

Correspondence to Gaetano A. Lanza.

Additional information

R. Nerla and D. Pitocco contributed equally to this article.

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Nerla, R., Pitocco, D., Zaccardi, F. et al. Effect of pioglitazone on systemic inflammation is independent of metabolic control and cardiac autonomic function in patients with type 2 diabetes. Acta Diabetol 47 (Suppl 1), 117–122 (2010). https://doi.org/10.1007/s00592-009-0150-3

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  • DOI: https://doi.org/10.1007/s00592-009-0150-3

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