The Comparative Effect of Pioglitazone and Metformin on Serum Osteoprotegerin, Adiponectin and Intercellular Adhesion Molecule Concentrations in Patients With Newly Diagnosed Type 2 Diabetes: A Randomized Clinical Trial Publisher Pubmed



Esteghamati A¹ ; Azizi R¹ ; Ebadi M¹ ; Noshad S¹ ; Mousavizadeh M¹ ; Afarideh M¹ ; Nakhjavani M¹ Show Affiliations
Source: Experimental and Clinical Endocrinology and Diabetes Published:2015

Abstract

Abstract Aim: The etiologic role of inflammatory pathways in the development of diabetic complications, especially cardiovascular events, has been established. The anti-inflammatory role of metformin and pioglitazone has been described; however, no study to date has compared the efficacy of these common oral agents in this regard. In this study, the authors aimed to compare the anti-inflammatory properties of pioglitazone and metformin, with respect to their effect on serum concentrations of highly sensitive C-reactive protein (hsCRP), osteoprotegerin (OPG), intercellular adhesion molecule-1 (ICAM-1) and adiponectin. Methods: In an open-label randomized clinical trial, 117 patients with newly diagnosed type 2 diabetes mellitus were visited; 84 fulfilled the inclusion criteria, and were randomly allocated to 2 arms receiving either 1000mg/d metformin or 30mg/d pioglitazone, respectively. Biochemical assessments were made at baseline and the end of the 3 months trial. Results: Significant reduction in FPG, insulin and HbA1c in women and men of both arms were observed. Log-hsCRP values significantly decreased in both arms. A decreasing, but non-significant trend in log-OPG levels was observed in women of the metformin arm (p=0.063). A greater reduction in log-ICAM levels was identifiable in men receiving pioglitazone compared to the other arm (p=0.008); in addition, the same trend was observed in log-OPG values (p=0.029). Nonetheless, reduction in log-ICAM and log-OPG levels was comparable between the 2 arms. A significant increase in adiponectin was observed in both men and women in the pioglitazone arm (p<0.001), whereas changes were non-significant in the metformin arm. Conclusion: Remarkably, patients receiving pioglitazone revealed more significant reduction in inflammatory markers. © Georg Thieme Verlag KG.