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Diabetes and Vascular Disease Research
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Pioglitazone plus a sulphonylurea or metformin is associated with increased lipoprotein particle size in patients with type 2 diabetes

Alfonso Perez

Takeda Global Research and Development, Inc., Lincolnshire, IL, U.S.

Mehmood Khan

Takeda Pharmaceuticals North America, Inc., Lincolnshire, IL, U.S.

Todd Johnson

Takeda Global Research and Development, Inc., Lincolnshire, IL, U.S.

Mahinda Karunaratne

Takeda Global Research and Development, Inc., Lincolnshire, IL, U.S.

Objective To determine the effect of pioglitazone plus metformin or a sulphonylurea on lipoprotein particle size and subclass distribution in patients with type 2 diabetes.

Methods Lipid profiles were determined for blood samples from patients participating in two randomised, double-blind, 24-week studies of pioglitazone 30 mg or 45 mg daily plus either metformin or a sulphonylurea.

Results Samples from 177 patients were evaluated; 96 of these patients received a sulphonylurea, and 81 received metformin. Pioglitazone combination treatment produced significant increases from baseline for average and peak low-density lipoprotein (LDL) particle size at weeks 12 and 24 (p<0.0001 for each; range 0.29–0.39 nm for average and 0.36–0.55 nm for peak particle size, respectively). Significant shifts in high-density lipoprotein (HDL) and LDL distribution showed an increase in large particles and a decrease in small particles. For pioglitazone plus metformin, significant increases in levels of apolipoprotein (Apo) AI, Apo AI/AII-containing HDL, and lipoprotein(a) also were noted, whereas Apo B levels decreased.

Conclusions These observed changes are thought to affect the atherogenic profile positively. Therefore, pioglitazone combination treatment may lead to decreased cardiovascular risk in patients with type 2 diabetes.

Key Words: pioglitazone • metformin • sulphonylurea • low-density lipoprotein • type 2 diabetes

Diabetes and Vascular Disease Research, Vol. 1, No. 1, 44-50 (2004)
DOI: 10.3132/dvdr.2004.006
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Pioglitazone and mechanisms of CV protection
QJM, December 2, 2009; (2009) hcp168v1.
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