Rosiglitazone and pioglitazone similarly improve insulin sensitivity and secretion, glucose tolerance and adipocytokines in type 2 diabetic patients.

OBJECTIVE: We examined the effects of rosiglitazone treatment on profiles of adipocytokines levels, postprandial insulin and glucose excursion, lipids levels, comparing with those of pioglitazone treatment in patients with type 2 diabetes mellitus (T2DM).

METHODS: Changes in body weight, haemoglobin A(1c )(HbA(1c)), glucose/insulin/C-peptide/free fatty acid (FFA) during 75 g oral glucose tolerance test (OGTT), HDL-/LDL-cholesterol, triglyceride (TG) and adipocytokines [tumour necrosis factor (TNF)-alpha, leptin and adiponectin] were measured in T2DM patients treated with rosiglitazone, 8 mg/day (n = 35), or pioglitazone, 45 mg/day (n = 21), for 3 months.

RESULTS: After rosiglitazone or pioglitazone treatment, HbA(1c )(8.6-7.2 vs. 8.3-6.9%, rosiglitazone vs. pioglitazone), fasting plasma glucose (190-144 vs. 178-140 mg/dl), fasting FFA (729-595 vs. 641-526 microEq/l), mean plasma glucose-OGTT (292-229 vs. 285-233 mg/dl) and mean FFA-OGTT (580-430 vs. 488-377 microEq/l) decreased similarly and all were statistically significant (p < 0.01). The insulinogenic index (DeltaI(0-120)/DeltaG(0-120)) (0.19-0.30 vs. 0.17-0.26) and Matsuda index of insulin sensitivity (2.0-3.1 and 2.7-4.3) increased (p < 0.01) similarly, despite increase in body weight (85-88 vs. 81-84 kg). TNF-alpha (3.8-3.4 vs. 5.2-4.5 pg/ml) decreased (p < 0.05) and adiponectin (6.3-17.8 vs. 7.1-16.4 microg/ml) increased (p < 0.01), while leptin did not change following either treatment. After rosiglitazone treatment, plasma HDL-cholesterol (34-38 mg/dl) and LDL-cholesterol (103-120 mg/dl) increased (p < 0.01), while TGs (177-167 mg/dl) did not change significantly. After pioglitazone treatment, plasma HDL-cholesterol (34-37 mg/dl) increased (p < 0.05), while LDL-cholesterol (104-105 mg/dl) did not change and TGs (153-106 mg/dl) decreased (p < 0.01).

CONCLUSIONS: Rosiglitazone and pioglitazone have similar beneficial effects on glycaemic control insulin sensitivity, insulin secretion and plasma adipocytokine levels. However, pioglitazone has a more beneficial effect on the plasma lipid profile than rosiglitazone.