Skip to main content

Advertisement

SpringerLink
Log in

The effects of rosiglitazone and metformin on inflammation and endothelial dysfunction in patients with type 2 diabetes mellitus

  • Original Article
  • Published:
Acta Diabetologica Aims and scope Submit manuscript

Abstract

Diabetic patients have a markedly increased risk of cardiovascular disease compared with non-diabetics. Two drug groups today target insulin resistance; biguanides and thiazolidinediones. In addition, these may have other effects on cardiovascular risk factors. The aim of this study was to evaluate the effects of metformin and rosiglitazone on non-traditional cardiovascular risk factors. Forty type 2 diabetic patients were randomized into metformin and rosiglitazone groups. After receiving the optimal doses, the patients were monitored for 12 weeks. Biochemical parameters, lipid parameters, CRP, insulin, c-peptide, and HbA1c levels were analyzed. VWF, PAI-1, ICAM-1, TNF-α, IL-6, E-selectin, and fibrinogen levels were measured in order to assess coagulation status and endothelial dysfunction. In the metformin group, body mass index, PPG, HbA1c, IL-6, ICAM-1, and TNF-α levels were significantly decreased after 12 weeks compared with the basal levels. IL-6 levels decreased from 75 pg/ml ± 20 to 42 pg/ml ± 9 (P 0.023) and TNF- α levels from 61 pg/ml ± 31 to 39 pg/ml ± 10 (P 0.018). In the rosiglitazone group, FPG, PPG, HbA1c, insulin, HOMA-IR, IL-6, and TNF-α levels decreased significantly after 12 weeks compared with the basal levels. IL-6 levels decreased from 78 pg/ml ± 21 to 41 pg/ml ± 9 (P 0.028) and TNF-α levels from 62 pg/ml ± 19 to 37 pg/ml ± 10 (P 0.012). At the end of the study, no significant differences were determined between groups. Insulin resistance and type 2 diabetes are strongly associated with low grade inflammation. Both metformin and rosiglitazone were effective in controlling inflammatory markers in addition to metabolic parameters.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Fonseca VA (2003) Management of diabetes mellitus and insulin resistance in patients with cardiovascular disease. Am J Cardiol 92(4A):50J–60J

    Article  PubMed  Google Scholar 

  2. Vijay SK, Mishra M, Kumar H, Tripathi K (2009) Effect of pioglitazone and rosiglitazone on mediators of endothelial dysfunction, markers of angiogenesis and inflammatory cytokines in type-2 diabetes. Acta Diabetol 46:27–33

    Article  PubMed  CAS  Google Scholar 

  3. Bailey CJ (1999) Insulin resistance and antidiabetic drugs. Biochem Pharmacol 58(10):1511–1520

    Article  PubMed  CAS  Google Scholar 

  4. Rosenberg DE, Jabbour SA, Goldstein BJ (2005) Insulin resistance, diabetes and cardiovascular risk: approaches to treatment. Diabetes Obes Metab 7(6):642–653

    Article  PubMed  CAS  Google Scholar 

  5. UK Prospective Diabetes Study (UKPDS) Group (1998) Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 352(9131):854–865

    Google Scholar 

  6. Taniguchi A, Fukushima M, Sakai M, Miwa K, Makita T, Nagata I et al (2000) Remnant-like particle cholesterol, triglycerides, and insulin resistance in nonobese Japanese type 2 diabetic patients. Diabetes Care 23:1766–1769

    Article  PubMed  CAS  Google Scholar 

  7. McAuley KA, Williams SM, Mann JI, Walker RJ, Lewis-Barned NJ, Temple LA, Duncan AW (2001) Diagnosing insulin resistance in the general population. Diabetes Care 24(3):460–464

    Article  PubMed  CAS  Google Scholar 

  8. De Jager J, Kooy A, Lehert P, Bets D, Wulffelé MG, Teerlink T, Scheffer PG, Schalkwijk CG, Donker AJ, Stehouwer CD (2005) Effects of short-term treatment with metformin on markers of endothelial function and inflammatory activity in type 2 diabetes mellitus: a randomized, placebo-controlled trial. Intern Med 257(1):100–109

    Article  Google Scholar 

  9. Esposito K, Ciotola M, Carleo D, Schisano B, Saccomanno F, Sasso FC, Cozzolino D, Assaloni R, Merante D, Ceriello A, Giugliano D (2006) Effect of rosiglitazone on endothelial function and inflammatory markers in patients with the metabolic syndrome. Diabetes Care 29(5):1071–1076

    Article  PubMed  CAS  Google Scholar 

  10. Samaha FF, Szapary PO, Iqbal N, Williams MM, Bloedon LT, Kochar A, Wolfe ML, Rader DJ (2006) effects of rosiglitazone on lipids, adipokines and inflammatory markers in nondiabetic patients with low high-density lipoprotein cholesterol and metabolic syndrome. Arterioscler Thromb Vasc Biol 26:624–630

    Article  PubMed  CAS  Google Scholar 

  11. Kim HJ, Kang ES, Kim DJ, Kim SH, Ahn CW, Cha BS, Nam M, Chung CH, Lee KW, Nam CM, Lee HC (2007) Effects of rosiglitazone and metformin on inflammatory markers and adipokines: decrease in interleukin-18 is an independent factor for the improvement of homeostasis model assessment-beta in type 2 diabetes mellitus. Clin Endocrinol 66:282–289

    Article  CAS  Google Scholar 

  12. Taniguchi A, Fukushima M, Nakai Y, Kuroe A, Yamano G, Yanagawa T, Ohgushi M, Ohya M, Yoshii S, Taki Y, Seino Y (2005) Soluble E-selectin, leptin, triglycerides, and insulin resistance in nonobese Japanese type 2 diabetic patients. Metabolism 54(3):376–380

    Article  PubMed  CAS  Google Scholar 

  13. Abbasi F, Chu JW, McLaughlin T, Lamendola C, Leary ET, Reaven GM (2004) Effect of metformin treatment on multiple cardiovascular disease risk factors in patients with type 2 diabetes mellitus. Metabolism 53(2):159–164

    Article  PubMed  CAS  Google Scholar 

  14. Sınger G, Granger DN (2007) Inflammatory responses underlying the microvascular dsyfunction associated with obesity and insulin resistance. Microcirculation 14:375–387

    Article  PubMed  Google Scholar 

  15. Nerla R, Pitocco D, Zaccardi F, Scalone G, Coviello I et al (2010) Effect of pioglitazone on systemic inflammation is independent of metabolic control and cardiac autonomic function in patients with type 2 diabetes. Acta Diabetol 47(supp 1):117–122

    Article  PubMed  CAS  Google Scholar 

  16. Nissen SE, Wolski K (2007) Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes. N Engl J Med 356(24):2457–2471

    Article  PubMed  CAS  Google Scholar 

  17. Home PD, Pocock JS, Gomis R, Hanefeld M, Jones NP, Komajda M, McMurray J (2007) Rosiglitazone evaluated for cardiovascular outcomes—an interm analysis. N Engl J Med 357:28–38

    Article  PubMed  CAS  Google Scholar 

  18. Home PD, Pocock SJ, Beck-Nielsen H, Curtis PS, Gomis R, Hanefeld M, Jones NP, Komajda M, McMurray JJ, RECORD Study Team (2009) Rosiglitazone evaluated for cardiovascular outcomes in oral agent combination therapy for type 2 diabetes (RECORD): a multicentre, randomised, open-label trial. Lancet 373(9681):2125–2135

    Article  PubMed  CAS  Google Scholar 

  19. Pantalone KM, Kattan MW, Yu C, Wells BJ, Arrigain S, Jain A, Atreja A, Zimmerman RS (2009) The risk of developing coronary artery disease or congestive heart failure, and overall mortality, in type 2 diabetic patients receiving rosiglitazone, pioglitazone, metformin, or sulfonylureas: a retrospective analysis. Acta Diabetol 46(2):145–154

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Internal Medicine and Medical Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, 61080, Turkey

    Evren Fidan

  2. Division of Endocrinology and Metabolism, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey

    H. Onder Ersoz, Mustafa Kocak & Cihangir Erem

  3. Division of Hematology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey

    Mustafa Yilmaz

  4. Department of Biochemistry,Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey

    Hulya Yilmaz & Caner Karahan

Authors
  1. Evren Fidan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. Onder Ersoz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mustafa Yilmaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hulya Yilmaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mustafa Kocak
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Caner Karahan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Cihangir Erem
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Evren Fidan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fidan, E., Onder Ersoz, H., Yilmaz, M. et al. The effects of rosiglitazone and metformin on inflammation and endothelial dysfunction in patients with type 2 diabetes mellitus. Acta Diabetol 48, 297–302 (2011). https://doi.org/10.1007/s00592-011-0276-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00592-011-0276-y

Keywords

Search

Navigation