Effects of Pioglitazone versus Simvastatin on Biomarkers of Inflammation in Patients on High Cardiovascular Risk

Abstract

High levels of fetuin-A has been linked to cardiovascular disease, possibly via modulating low-grade systemic inflammation. We performed a subanalysis from the PIOSTAT study to investigate a possible link between fetuin-A and the inflammatory biomarker hs-CRP. 66 nondiabetic individuals at cardiovascular risk were randomized to either pioglitazone, simvastatin, or the combination of both, and followed for 12 weeks. At study endpoint, correlations between serum fetuin-A, hs-CRP, blood lipids, PAI-1, MMP-9, HOMA-IR, and liver transaminases were investigated by Spearman rank correlation. Changes in fetuin-A concentration did not correlate to changes in hs-CRP (r=0.19, p=0.16). A positive correlation was found for change of HOMA-IR value (r=0.33, p=0.01) and for the AST/ALT ratio (p<0.05). Our data suggest that the previously observed correlation between elevated circulating fetuin-A and hs-CRP in epidemiological studies may not reflect a causal relationship in nondiabetic patients on high cardiovascular risk.

• References

• 1 Hennige AM, Staiger H, Wicke C, Machicao F, Fritsche A, Häring HU, Stefan N. PLoS ONE 2008; 3: e1765
• 2 Weikert C, Stefan N, Schulze MB, Pischon T, Berger K, Joost HG, Häring HU, Boeing H, Fritsche A. Circulation 2008; 118: 2555-2562
• 3 Ix JH, Shlipak MG, Brandenburg VM, Ali S, Ketteler M, Whooley MA. Circulation 2006; 113: 1760-1767
• 4 Stefan N, Fritsche A, Weikert C, Boeing H, Joost HG, Häring HU, Schulze MB. Diabetes 2008; 57: 2762-2767
• 5 Reinehr T, Roth CL. J Clin Endocrinol Metab 2008; 93: 4479-4485
• 6 Mori K, Emoto M, Araki T, Yokoyama H, Lee E, Teramura M, Koyama H, Shoji T, Inaba M, Nishizawa Y. Metabolism 2008; 57: 1248-1252
• 7 Hanefeld M, Marx M, Pfützner A, Baurecht W, Lübben G, Karagiannis E, Stier U, Forst T. J Am Coll Cardiol 2007; 49: 290-297
• 8 Dervisoglu E, Kir HM, Kalender B, Caglayan C, Eraldemir C. Cytokine 2008; 44: 323-327
• 9 Roos M, von Eynatten M, Heemann U, Rothenbacher D, Brenner H, Breitling LP, Am J. Cardiol 2010; 105: 1666-1672