Inhibitory effect of pioglitazone on carotid arterial wall thickness in type 2 diabetes

Abstract

There have been increasing evidences that thiazolidinediones, peroxisome proliferator-activated receptor γ (PPARγ) agonists, may have some antiatherogenic actions. We have previously reported that troglitazone has a potent inhibitory effect on common carotid arterial intima-media thickness (IST) in subjects with type 2 diabetes. However, some studies suggested a possibility that PPARγ activators may have protoatherogenic actions, raising concern about their detrimental effects in diabetic subjects. In the present study, we investigated the effect of treatment with pioglitazone, another PPARγ agonist, on Ist in a total of 106 Japanese subjects with type 2 diabetes. Pioglitazone (30 mg daily) was administered for 6 months in 53 patients. Compared to control group (n=53), the group given pioglitazone showed a significant decrease in Ist as early as 3 months after the administration. The decrease in IST was also found after 6 months (IST change: -0.084[SE 0.023] mm vs. control 0.022[SE 0.006] mm, P<0.001), although the difference between those after 3 and 6 months did not reach any statistical significance. These findings indicate that thiazolidinediones cause an inhibition of early atherosclerotic process through PPARγ activation.