Effects of Pretreatment with Low-dose Metformin on Metabolic Parameters and Weight Gain by Pioglitazone in Japanese Patients with Type 2 Diabetes
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概要
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Objective We investigated whether or not "low dose" metformin could prevent weight gain induced by pioglitazone. Research Design and Methods Sixty-nine patients with type 2 diabetes received 500-750 mg metformin a day for 12 weeks as an observation period before the start of the intervention. After an observation period, inadequately controlled patients (hemoglobin A1c ≥7.5%, n=34) received additional treatment with 15 mg pioglitazone (+P, M+P group). The other patients (n= 35) continued metformin monotherapy (Met group). In addition, another group consisting of 28 patients treated with 15 mg pioglitazone alone (Pio group) was observed. Body mass index (BMI), as well as several clinical parameters of glycemic control and lipid metabolism, was compared before and after 24 weeks of intervention. Results BMI increased significantly in the Pio group [24.0±3.8 vs. 24.8±4.3 kg/m2, (mean ± SD), p<0.001], but not in the M+P group (25.1±3.5 vs. 25.3±3.4 kg/m2, NS) and Met group (24.0±3.3 vs. 24.0±3.5 kg/m2, NS). In addition to improvement in glycemic control, a significant reduction in the atherogenic index of plasma (AIP), defined as log [TG ×0.0112/HDL-C ×0.02586], was observed in the Pio group (0.06±0.23 vs. -0.04±0.27, p<0.05) and M+P group (0.08±0.24 vs. -0.001±0.252, p<0.01), but not in the Met group. Conclusion This study indicates potential benefits of the addition of pioglitazone to "low dose" metformin in terms of improvement of glucose and lipid metabolism without weight gain.
著者
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Atsumi Yoshihito
Department Of Internal Medicine Saiseikai Central Hospital
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Tabata Mitsuhisa
Department Of Internal Medicine Hiratsuka City Hospital
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Kawai Toshihide
Department Of Astrophysics Nagoya University
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Itoh Hiroshi
Department Of Advanced Materials Science Faculty Of Engineering Kagawa University
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Shimada Akira
Department of Chemistry Faculty of Science Osaka City University
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Hirata Takumi
Department of Internal Medicine, Saitama Social Insurance Hospital, Japan
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Hirata Takumi
Department of Internal Medicine, School of Medicine, Keio University
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Kawai Toshihide
Department of Internal Medicine, School of Medicine, Keio University
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Tabata Mitsuhisa
Department of Internal Medicine, School of Medicine, Keio University
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Funae Osamu
Department of Internal Medicine, Saiseikai Central Hospital
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