Pioglitazone reduces epicardial fat and improves diastolic function in patients with type 2 diabetes

© 2022 John Wiley & Sons Ltd..

AIMS: To examine the effect of pioglitazone on epicardial (EAT) and paracardial adipose tissue (PAT) and measures of diastolic function and insulin sensitivity in patients with type 2 diabetes mellitus (T2DM).

METHODS: Twelve patients with T2DM without clinically manifest cardiovascular disease and 12 subjects with normal glucose tolerance (NGT) underwent cardiac magnetic resonance imaging to quantitate EAT and PAT and diastolic function before and after pioglitazone treatment for 24 weeks. Whole-body insulin sensitivity was measured with a euglycaemic insulin clamp and the Matsuda Index (oral glucose tolerance test).

RESULTS: Pioglitazone reduced glycated haemoglobin by 0.9% (P < 0.05), increased HDL cholesterol by 7% (P < 0.05), reduced triacylglycerol by 42% (P < 0.01) and increased whole-body insulin-stimulated glucose uptake by 71% (P < 0.01) and Matsuda Index by 100% (P < 0.01). In patients with T2DM, EAT (P < 0.01) and PAT (P < 0.01) areas were greater compared with subjects with NGT, and decreased by 9% (P = 0.03) and 9% (P = 0.09), respectively, after pioglitazone treatment. Transmitral E/A flow rate and peak left ventricular flow rate (PLVFR) were reduced in T2DM versus NGT (P < 0.01) and increased following pioglitazone treatment (P < 0.01-0.05). At baseline normalized PLVFR inversely correlated with EAT (r = -0.45, P = 0.03) but not PAT (r = -0.29, P = 0.16). E/A was significantly and inversely correlated with EAT (r = -0.55, P = 0.006) and PAT (r = -0.40, P = 0.05). EAT and PAT were inversely correlated with whole-body insulin-stimulated glucose uptake (r = -0.68, P < 0.001) and with Matsuda Index (r = 0.99, P < 0.002).

CONCLUSION: Pioglitazone reduced EAT and PAT areas and improved left ventricular (LV) diastolic function in T2DM. EAT and PAT are inversely correlated (PAT less strongly) with LV diastolic function and both EAT and PAT are inversely correlated with measures of insulin sensitivity.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:25

Enthalten in:

Diabetes, obesity & metabolism - 25(2023), 2 vom: 01. Feb., Seite 426-434

Sprache:

Englisch

Beteiligte Personen:

Moody, Alexander J [VerfasserIn]
Molina-Wilkins, Marjorie [VerfasserIn]
Clarke, Geoffrey D [VerfasserIn]
Merovci, Aurora [VerfasserIn]
Solis-Herrera, Carolina [VerfasserIn]
Cersosimo, Eugenio [VerfasserIn]
Chilton, Robert J [VerfasserIn]
Iozzo, Patricia [VerfasserIn]
Gastaldelli, Amalia [VerfasserIn]
Abdul-Ghani, Muhammad [VerfasserIn]
DeFronzo, Ralph A [VerfasserIn]

Links:

Volltext

Themen:

Blood Glucose
Diastolic function
Epicardial and paracardial fat
Glucose
Hypoglycemic Agents
IY9XDZ35W2
Insulin
Insulin sensitivity
Journal Article
Pioglitazone
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Thiazolidinediones
Type 2 diabetes
X4OV71U42S

Anmerkungen:

Date Completed 04.01.2023

Date Revised 02.02.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1111/dom.14885

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM347203272