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Pioglitazone and sibutramine combination effects on glucose and lipid metabolism in obese type 2 diabetic patients
XVIII S.I.S.A. National Congress
310
MATRIX METALLOPROTEINASES VALUES IN DIABETIC PATIENTS DURING ACUTE CORONARY SYNDROME AND AFTER THE ACUTE EVENT
DOXAZOSIN IMPROVES BLOOD PRESSURE AND METABOLIC PARAMETERS IN IMPAIRED GLUCOSE TOLERANCE PATIENTS IN THERAPY WITH ACARBOSE
G. Derosa, F. Scalisel, M.A. Avanzini2, E. Fogari, M.N. Piccinni, G. Bertone, L. Ciccarelli, F. Pricolo, S. Salvadeo, and R. Fogari
G. Derosa, 1A.F.G. Cicero, L. Ciccarelli, M.N. Piccinni, G. Bertone, F. Pricolo, S. Salvadeo, M. Ghelfi, I. Ferrari, E. Fogari, S. Paniga, S. Galli and R. Fogari
Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, 1Catheterization Laboratory, Cardiovascular Department, Policlinico di Monza, Monza, 2Research Laboratories Pediatric Oncohematology, IRCCS Policlinico S. Matteo, Pavia, Italy
Department of Internal Medicine and Therapeutics, University of Pavia, PAVIA, 1Department of Clinical Medicine and Applied Biotechnology, University of Bologna, BOLOGNA
PURPOSE: matrix metalloproteinases (MMPs) are critical for vascular remodelling by regulating degradation of the extracellular matrix. We evaluated MMP2 and MMP9 levels in diabetic or nondiabetic patients with acute coronary syndrome (ACS) and after 3 months. METHODS: we detected by ELISA serum MMP2 and MMP9 levels in 40 patients aged (mean+SD) 68+9 years with ACS, evaluated at diagnosis and after a 3-months follow-up. Of these, 27 patients aged 67+11 years resulted nondiabetics, and 13 patients aged 76+5 years resulted diabetics. RESULTS: MMP2 and MMP9 levels were not significantly different in both groups during ACS; MMP2 levels were significantly higher (p< 0.0001) in nondiabetic patients end significantly higher (p=0.002) in diabetic patients in the period of the acute event compared to the 3months follow-up period, respectively. MMP9 levels were not significantly increased (p= ns) in nondiabetic patients and significantly higher (p=0.046) in the period of the acute event compared to the 3months follow-up period, respectively. CONCLUSIONS: diabetic and nondiabetic patients with ACS have MMP2 levels significantly higher compared to the 3-months follow-up period, but MMP9 is higher only in diabetic patients compared to the 3-months follow-up period.
We enrolled 32 impaired glucose tolerance patients (IGT) [diagnosis with oral glucose tolerance test (OGTT)]. All subjects were taking 14001600 Kcal diet and acarbose, 50 mg/tid, and were randomized in two groups to receive doxazosin, 4 mg/od, or placebo for three months. Furthermore, all subjects were titrated to acarbose till 100 mg/tid for further three months. We assessed body mass index (BMI), glycosylated haemoglobin (HbAIc), fasting (FPG) and postprandial (PPG) plasma glucose, fasting (FPI) and postprandial (PPI) plasma insulin, homeostasis model assessment (HOMA index), systolic (SBP) and diastolic (DBP) blood pressure, total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), and triglycerides (Tg). All variables were evaluated at baseline, and after 3, and 6 months. At the end of the study, OGTT was performed to all subjects. Significant SBP and DBP decrease was observed in doxazosin group (p< 0.05, respectively) compared to placebo group after 3 months. A significant BMI, HbAlc, FPG, and PPG improvement was present in both groups (p< 0.05, respectively), whereas a significant FPI, HOMA index, TC, LDL-C, HDL-C, and Tg improvement was observed in doxazosin group (p< 0.05, respectively) after 6 months. Further SBP and DBP decrease was evaluated in doxazosin group (p< 0.01, respectively) compared to placebo group after 6 months. Normal OGTT was determined in all patients that completed the study. Acarbose is effective to prevent diabetes condition. Doxazosin in association with acarbose improved insulin sensitivity and lipid profile, beyond antihypertensive action.
MOXONIDINE ACTION ON GLUCOSE AND LIPID METABOLISM IN HYPERTENSIVE PATIENTS WITH METABOLIC SYNDROME
PIOGLITAZONE AND SIBUTRAMINE COMBINATION EFFECTS ON GLUCOSE AND LIPID METABOLISM IN OBESE TYPE 2 DIABETIC PATIENTS
G. Derosa, 1A.F.G. Cicero, L. Ciccarelli, M.N. Piccinni, G. Bertone, F. Pricolo, S. Salvadeo, M. Ghelfi, I. Ferrari, E. Fogari, S. Paniga, S. Galli and R. Fogari Department of Internal Medicine and Therapeutics, University of Pavia, PAVIA, 1Department of Clinical Medicine and Applied Biotechnology, University of Bologna, BOLOGNA The autonomic nervous system plays an important part in the homeostasis of blood pressure and the sympathetic overactivity could contribute to metabolic disease like glycaemic intolerance or insulin resistance. We enrolled 44 subjects with mild hypertension and type 2 diabetes mellitus in non pharmacologic therapy (1400-1600 Kcal diet and constant physical activity). We gave moxonidine, 0.2 mg/day for three months. After three months, such subjects were randomized to increase moxonidine, 0.4 mg/day, or to add irbesartan, 150 mg/day, for further three months. We assessed body mass index (BMI), glycosylated haemoglobin (HbAlc), fasting (FPG) and postprandial (PPG) plasma glucose, fasting (FPI) and postprandial (PPI) plasma insulin, homeostasis model assessment (HOMA index), systolic (SBP) and diastolic (DBP) blood pressure, total cholesterol (TC), low-density lipoprotein-cholesterol (LDLC), high-density lipoprotein-cholesterol (HDL-C), and triglycerides (Tg). All variables were evaluated at baseline, and after 3, and 6 months. No improvement was obtained in all considered parameters after three months with moxonidine, while we observed a significant decrease in SBP and DBP (p< 0.05, respectively). After randomization, we observed a significant reduction of HbAlc, FPG, FPI, HOMA index, HDL-C, and Tg (p< 0.05, respectively) in moxonidine group compared to combination therapy, while SBP and DBP values were decreased in both groups (p< 0.02 and p< 0.01, respectively). Moxonidine at full dosage reduced not only blood pressure values, but also improved some glycaemic and lipid parameters.
Derosa G., 1Cicero A.F.G., 2Ragonesi P.D., Ciccarelli L., Piccinni M.N., Bertone G., Pricolo F., Salvadeo S., Ghelfi M., Ferrari I., Paniga S., Galli S., and Fogari R. Department of Internal Medicine and Therapeutics, University of Pavia, PAVIA, 1Department of Clinical Medicine and Applied Biotechnology, University of Bologna, BOLOGNA, 2Diabetes Care Unit, S. Carlo Hospital, MILAN, Italy Pioglitazone therapy reduces insulin-resistance in type 2 diabetic patients, but could give weight increase. We evaluated glucose and lipid metabolism in obese, type 2 diabetic patients. Patients were taking pioglitazone and all patients were resulted intolerant to mefformin. We enrolled 40 obese patients with na'(ve type 2 diabetes in pioglitazone therapy (30 mg/day) were randomly assigned to receive sibutramine, 10 mg/day (n=20) or placebo (n=20) for 6 months. We assessed body mass index (BMI), fasting (FPG) and postprandial (PPG) plasma glucose, glycosylated hemoglobin (HbAI=), fasting (FPI) and postprandial (PPI) plasma insulin, homeostasis model assessment (HOMA index), lipid [total cholesterol (TC), and triglycerides (Tg)], lipoprotein [low-density lipoprotein (LDL-C), and high-density lipoprotein (HDL-C)], apolipoprotein [apolipoprotein A-I (Apo A-I), and apolipoprotein B (Apo B)] fractions, and lipoprotein (a) [Lp(a)]. All variables were evaluated at baseline, and after 3, and 6 months. BMI decrease was observed in sibutramine group (p< 0.05). We observed a significant improvement from baseline to 6 months in HbAlc, FPG, PPG, FPI, PPI, and HOMA index (p< 0.05, respectively) in both treatments. TC and LDL-C were significantly decreased in both groups (p< 0.05, respectively), while Tg were significantly decreased in sibutramine group (p< 0.05) after 6 months. Pioglitazone and sibutramine combination could be effective to reduce weight increase due to thiazolidinedione therapy in obese, type 2 diabetic patients. Furthermore, sibutramine improved Tg levels.
310
MATRIX METALLOPROTEINASES VALUES IN DIABETIC PATIENTS DURING ACUTE CORONARY SYNDROME AND AFTER THE ACUTE EVENT
DOXAZOSIN IMPROVES BLOOD PRESSURE AND METABOLIC PARAMETERS IN IMPAIRED GLUCOSE TOLERANCE PATIENTS IN THERAPY WITH ACARBOSE
G. Derosa, F. Scalisel, M.A. Avanzini2, E. Fogari, M.N. Piccinni, G. Bertone, L. Ciccarelli, F. Pricolo, S. Salvadeo, and R. Fogari
G. Derosa, 1A.F.G. Cicero, L. Ciccarelli, M.N. Piccinni, G. Bertone, F. Pricolo, S. Salvadeo, M. Ghelfi, I. Ferrari, E. Fogari, S. Paniga, S. Galli and R. Fogari
Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, 1Catheterization Laboratory, Cardiovascular Department, Policlinico di Monza, Monza, 2Research Laboratories Pediatric Oncohematology, IRCCS Policlinico S. Matteo, Pavia, Italy
Department of Internal Medicine and Therapeutics, University of Pavia, PAVIA, 1Department of Clinical Medicine and Applied Biotechnology, University of Bologna, BOLOGNA
PURPOSE: matrix metalloproteinases (MMPs) are critical for vascular remodelling by regulating degradation of the extracellular matrix. We evaluated MMP2 and MMP9 levels in diabetic or nondiabetic patients with acute coronary syndrome (ACS) and after 3 months. METHODS: we detected by ELISA serum MMP2 and MMP9 levels in 40 patients aged (mean+SD) 68+9 years with ACS, evaluated at diagnosis and after a 3-months follow-up. Of these, 27 patients aged 67+11 years resulted nondiabetics, and 13 patients aged 76+5 years resulted diabetics. RESULTS: MMP2 and MMP9 levels were not significantly different in both groups during ACS; MMP2 levels were significantly higher (p< 0.0001) in nondiabetic patients end significantly higher (p=0.002) in diabetic patients in the period of the acute event compared to the 3months follow-up period, respectively. MMP9 levels were not significantly increased (p= ns) in nondiabetic patients and significantly higher (p=0.046) in the period of the acute event compared to the 3months follow-up period, respectively. CONCLUSIONS: diabetic and nondiabetic patients with ACS have MMP2 levels significantly higher compared to the 3-months follow-up period, but MMP9 is higher only in diabetic patients compared to the 3-months follow-up period.
We enrolled 32 impaired glucose tolerance patients (IGT) [diagnosis with oral glucose tolerance test (OGTT)]. All subjects were taking 14001600 Kcal diet and acarbose, 50 mg/tid, and were randomized in two groups to receive doxazosin, 4 mg/od, or placebo for three months. Furthermore, all subjects were titrated to acarbose till 100 mg/tid for further three months. We assessed body mass index (BMI), glycosylated haemoglobin (HbAIc), fasting (FPG) and postprandial (PPG) plasma glucose, fasting (FPI) and postprandial (PPI) plasma insulin, homeostasis model assessment (HOMA index), systolic (SBP) and diastolic (DBP) blood pressure, total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), and triglycerides (Tg). All variables were evaluated at baseline, and after 3, and 6 months. At the end of the study, OGTT was performed to all subjects. Significant SBP and DBP decrease was observed in doxazosin group (p< 0.05, respectively) compared to placebo group after 3 months. A significant BMI, HbAlc, FPG, and PPG improvement was present in both groups (p< 0.05, respectively), whereas a significant FPI, HOMA index, TC, LDL-C, HDL-C, and Tg improvement was observed in doxazosin group (p< 0.05, respectively) after 6 months. Further SBP and DBP decrease was evaluated in doxazosin group (p< 0.01, respectively) compared to placebo group after 6 months. Normal OGTT was determined in all patients that completed the study. Acarbose is effective to prevent diabetes condition. Doxazosin in association with acarbose improved insulin sensitivity and lipid profile, beyond antihypertensive action.
MOXONIDINE ACTION ON GLUCOSE AND LIPID METABOLISM IN HYPERTENSIVE PATIENTS WITH METABOLIC SYNDROME
PIOGLITAZONE AND SIBUTRAMINE COMBINATION EFFECTS ON GLUCOSE AND LIPID METABOLISM IN OBESE TYPE 2 DIABETIC PATIENTS
G. Derosa, 1A.F.G. Cicero, L. Ciccarelli, M.N. Piccinni, G. Bertone, F. Pricolo, S. Salvadeo, M. Ghelfi, I. Ferrari, E. Fogari, S. Paniga, S. Galli and R. Fogari Department of Internal Medicine and Therapeutics, University of Pavia, PAVIA, 1Department of Clinical Medicine and Applied Biotechnology, University of Bologna, BOLOGNA The autonomic nervous system plays an important part in the homeostasis of blood pressure and the sympathetic overactivity could contribute to metabolic disease like glycaemic intolerance or insulin resistance. We enrolled 44 subjects with mild hypertension and type 2 diabetes mellitus in non pharmacologic therapy (1400-1600 Kcal diet and constant physical activity). We gave moxonidine, 0.2 mg/day for three months. After three months, such subjects were randomized to increase moxonidine, 0.4 mg/day, or to add irbesartan, 150 mg/day, for further three months. We assessed body mass index (BMI), glycosylated haemoglobin (HbAlc), fasting (FPG) and postprandial (PPG) plasma glucose, fasting (FPI) and postprandial (PPI) plasma insulin, homeostasis model assessment (HOMA index), systolic (SBP) and diastolic (DBP) blood pressure, total cholesterol (TC), low-density lipoprotein-cholesterol (LDLC), high-density lipoprotein-cholesterol (HDL-C), and triglycerides (Tg). All variables were evaluated at baseline, and after 3, and 6 months. No improvement was obtained in all considered parameters after three months with moxonidine, while we observed a significant decrease in SBP and DBP (p< 0.05, respectively). After randomization, we observed a significant reduction of HbAlc, FPG, FPI, HOMA index, HDL-C, and Tg (p< 0.05, respectively) in moxonidine group compared to combination therapy, while SBP and DBP values were decreased in both groups (p< 0.02 and p< 0.01, respectively). Moxonidine at full dosage reduced not only blood pressure values, but also improved some glycaemic and lipid parameters.
Derosa G., 1Cicero A.F.G., 2Ragonesi P.D., Ciccarelli L., Piccinni M.N., Bertone G., Pricolo F., Salvadeo S., Ghelfi M., Ferrari I., Paniga S., Galli S., and Fogari R. Department of Internal Medicine and Therapeutics, University of Pavia, PAVIA, 1Department of Clinical Medicine and Applied Biotechnology, University of Bologna, BOLOGNA, 2Diabetes Care Unit, S. Carlo Hospital, MILAN, Italy Pioglitazone therapy reduces insulin-resistance in type 2 diabetic patients, but could give weight increase. We evaluated glucose and lipid metabolism in obese, type 2 diabetic patients. Patients were taking pioglitazone and all patients were resulted intolerant to mefformin. We enrolled 40 obese patients with na'(ve type 2 diabetes in pioglitazone therapy (30 mg/day) were randomly assigned to receive sibutramine, 10 mg/day (n=20) or placebo (n=20) for 6 months. We assessed body mass index (BMI), fasting (FPG) and postprandial (PPG) plasma glucose, glycosylated hemoglobin (HbAI=), fasting (FPI) and postprandial (PPI) plasma insulin, homeostasis model assessment (HOMA index), lipid [total cholesterol (TC), and triglycerides (Tg)], lipoprotein [low-density lipoprotein (LDL-C), and high-density lipoprotein (HDL-C)], apolipoprotein [apolipoprotein A-I (Apo A-I), and apolipoprotein B (Apo B)] fractions, and lipoprotein (a) [Lp(a)]. All variables were evaluated at baseline, and after 3, and 6 months. BMI decrease was observed in sibutramine group (p< 0.05). We observed a significant improvement from baseline to 6 months in HbAlc, FPG, PPG, FPI, PPI, and HOMA index (p< 0.05, respectively) in both treatments. TC and LDL-C were significantly decreased in both groups (p< 0.05, respectively), while Tg were significantly decreased in sibutramine group (p< 0.05) after 6 months. Pioglitazone and sibutramine combination could be effective to reduce weight increase due to thiazolidinedione therapy in obese, type 2 diabetic patients. Furthermore, sibutramine improved Tg levels.