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Horm Metab Res 2005; 37(8): 510-515
DOI: 10.1055/s-2005-870320
Original Clinical
© Georg Thieme Verlag KG Stuttgart · New York

Pioneer Study: PPARγ Activation Results in Overall Improvement of Clinical and Metabolic Markers Associated with Insulin Resistance Independent of Long-term Glucose Control

A.  Pfützner1, 2 , C.  Hohberg1 , G.  Lübben3 , S.  Pahler1 , A.  H.  Pfützner1 , P.  Kann1, 4 , T.  Forst1
  • 1 IKFE-Institute for Clinical Research and Development, Mainz, Germany
  • 2 University of Applied Sciences, Rheinbach, Germany
  • 3 Takeda Pharma GmbH, Aachen, Germany
  • 4 University Hospital, Department of Endocrinology and Diabetes, Marburg, Germany
Further Information

Publication History

Received 15 December 2004

Accepted after revision 22 March 2005

Publication Date:
01 September 2005 (online)

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Abstract

New scores and biochemical markers have recently been published for diagnosis of insulin resistance and β-cell dysfunction (such as intact proinsulin, adiponectin, IRISII-score). One goal of this 6-month prospective controlled study was to evaluate the impact of pioglitazone (45 mg) vs. glimepiride (1-6 mg, in the intend to optimize therapy) on these markers. Observation parameters were: IRIS-II score, HOMA-score, ATP III score, HbA1c, fasting glucose, lipids, intact proinsulin, adiponectin, and adverse events. The study was completed by 173 patients (66 female, 107 male, age ± STD: 63 ± 8 years, disease duration: 7.2 ± 7.2 years, HbA1c: 7.53 ± 0.85 %, pioglitazone arm: 89 patients). The groups were not different for any of the observation parameters at baseline, and a similar reduction in HbA1c was seen in both groups (p < 0.001). In the pioglitazone group, reductions were observed for the IRIS-II and HOMA scores (p < 0.001 vs. glimepiride at endpoint) fasting glucose (p < 0.001), insulin (p < 0.001), LDL/HDL ratio (p < 0.001), hsCRP (p < 0.05), intact proinsulin (p < 0.001), and an increase was seen in HDL (p < 0.001), adiponectin (p < 0.001) and BMI (p < 0.001). In conclusion, treatment with pioglitazone resulted in an improvement of markers for insulin resistance and β-cell dysfunction, independent from blood glucose control. Adiponectin, intact proinsulin, and the IRIS-II score may be suitable parameters for monitoring of these additional beneficial therapeutic effects.

Key words

Intact proinsulin · Adiponectin · IRIS-II score · HOMA score

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Prof. Dr. Andreas Pfützner

Institute for Clinical Research and Development

Parcusstr. 8 · D-55116 Mainz · Germany

Phone: +49 (6131) 576 36 10

Fax: +49 (6131) 576 36 11

Email: AndreasP@ikfe.de