Pioglitazone Reduces Signs of Metabolic Syndrome

Pioglitazone treatment of nondiabetic patients with metabolic syndrome appears to reduce atherogenic features of this condition, Philadelphia-based researchers report.

Lead investigator Dr. Daniel Rader of the University of Pennsylvania Medical Center stated that, "pioglitazone raises HDL levels and has other effects that are potentially beneficial from a cardiovascular standpoint in persons with metabolic syndrome, but not diabetes…These effects are not directly related to lowering of blood glucose."

As published in a recent journal, Dr. Rader and colleagues evaluated 60 patients with metabolic syndrome who were randomized to pioglitazone or placebo.

At 6 weeks, pioglitazone increased HDL cholesterol by 15%. At 12 weeks, the corresponding increase was 14%. These increases were significantly correlated to changes in adiponectin, but not to changes in insulin resistance.

Pioglitazone increased mean serum levels of adiponectin by 111% and reduced median C-reactive protein levels by 31% and mean resistin levels by 10%.

Serum triglycerides and LDL cholesterol concentrations were not changed by pioglitazone treatment. However, the number of small LDL particles was reduced by a significant 18%.

These findings, continued Dr. Rader, "support the concept that pioglitazone could potentially be useful in reducing cardiovascular risk even in non-diabetics with the metabolic syndrome."

This "would be an off-label use, but is being done by some physicians in selected patients," he added.

Arterioscler Thromb Vasc Biol 2006;26:182-188.

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Journal of the American College of Nutrition (Vol. 24, Issue 6, pp 510-515)