Effect of pioglitazone therapy on myocardial and hepatic steatosis in insulin-treated patients with type 2 diabetes

Ivana Zib, Aris N. Jacob, Ildiko Lingvay, Karin Salinas, Jonathan M. McGavock, Philip Raskin, Lidia S. Szczepaniak

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

High levels of myocardial and hepatic triglyceride are common in obesity and type 2 diabetes. Monotherapy with thiazolidinedione agents reduces hepatic steatosis by up to 50% in patients with type 2 diabetes. It is not known if treatment with a thiazolidinedione added to insulin has a similar beneficial antisteatotic effect. The aim of our study was to determine whether the addition of pioglitazone to insulin treatment in patients with type 2 diabetes has antisteatotic action in the heart and the liver. Thirty-two patients were randomized to 6 months of treatment with insulin or insulin plus pioglitazone. In addition to blood tests, we evaluated myocardial and hepatic triglyceride content, as well as subcutaneous and visceral fat mass at the L2 level, by magnetic resonance spectroscopy and imaging, respectively. Despite weight and subcutaneous fat mass gain, hemoglobin A1c was significantly reduced by both treatments. Myocardial and hepatic triglyceride contents were reduced by the treatment with pioglitazone plus insulin (p = .02 and .03, respectively) but not by the treatment with insulin. Systolic and diastolic blood pressure and heart function remained unchanged in both groups. The addition of pioglitazone to insulin therapy reduced myocardial and hepatic steatosis, consistent with the reported ability of the thiazolidinedione agents to redistribute fat from nonadipose to subcutaneous adipose depots.

Original languageEnglish (US)
Pages (from-to)230-236
Number of pages7
JournalJournal of Investigative Medicine
Volume55
Issue number5
DOIs
StatePublished - Jul 2007

Fingerprint

pioglitazone
Medical problems
Type 2 Diabetes Mellitus
Insulin
Liver
Triglycerides
Subcutaneous Fat
Fats
Therapeutics
Magnetic resonance spectroscopy
Blood Pressure
Intra-Abdominal Fat
Blood pressure
Hematologic Tests
Hemoglobins
Blood

Keywords

  • Myocardial and hepatic steatosis
  • Pioglitazone/insulin therapy
  • Type 2 diabetes

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Effect of pioglitazone therapy on myocardial and hepatic steatosis in insulin-treated patients with type 2 diabetes. / Zib, Ivana; Jacob, Aris N.; Lingvay, Ildiko; Salinas, Karin; McGavock, Jonathan M.; Raskin, Philip; Szczepaniak, Lidia S.

In: Journal of Investigative Medicine, Vol. 55, No. 5, 07.2007, p. 230-236.

Research output: Contribution to journalArticle

Zib, Ivana ; Jacob, Aris N. ; Lingvay, Ildiko ; Salinas, Karin ; McGavock, Jonathan M. ; Raskin, Philip ; Szczepaniak, Lidia S. / Effect of pioglitazone therapy on myocardial and hepatic steatosis in insulin-treated patients with type 2 diabetes. In: Journal of Investigative Medicine. 2007 ; Vol. 55, No. 5. pp. 230-236.
@article{bef0e29b3fbe46068389c912c3461bcb,
title = "Effect of pioglitazone therapy on myocardial and hepatic steatosis in insulin-treated patients with type 2 diabetes",
abstract = "High levels of myocardial and hepatic triglyceride are common in obesity and type 2 diabetes. Monotherapy with thiazolidinedione agents reduces hepatic steatosis by up to 50{\%} in patients with type 2 diabetes. It is not known if treatment with a thiazolidinedione added to insulin has a similar beneficial antisteatotic effect. The aim of our study was to determine whether the addition of pioglitazone to insulin treatment in patients with type 2 diabetes has antisteatotic action in the heart and the liver. Thirty-two patients were randomized to 6 months of treatment with insulin or insulin plus pioglitazone. In addition to blood tests, we evaluated myocardial and hepatic triglyceride content, as well as subcutaneous and visceral fat mass at the L2 level, by magnetic resonance spectroscopy and imaging, respectively. Despite weight and subcutaneous fat mass gain, hemoglobin A1c was significantly reduced by both treatments. Myocardial and hepatic triglyceride contents were reduced by the treatment with pioglitazone plus insulin (p = .02 and .03, respectively) but not by the treatment with insulin. Systolic and diastolic blood pressure and heart function remained unchanged in both groups. The addition of pioglitazone to insulin therapy reduced myocardial and hepatic steatosis, consistent with the reported ability of the thiazolidinedione agents to redistribute fat from nonadipose to subcutaneous adipose depots.",
keywords = "Myocardial and hepatic steatosis, Pioglitazone/insulin therapy, Type 2 diabetes",
author = "Ivana Zib and Jacob, {Aris N.} and Ildiko Lingvay and Karin Salinas and McGavock, {Jonathan M.} and Philip Raskin and Szczepaniak, {Lidia S.}",
year = "2007",
month = "7",
doi = "10.2310/6650.2007.00003",
language = "English (US)",
volume = "55",
pages = "230--236",
journal = "Journal of Investigative Medicine",
issn = "1081-5589",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Effect of pioglitazone therapy on myocardial and hepatic steatosis in insulin-treated patients with type 2 diabetes

AU - Zib, Ivana

AU - Jacob, Aris N.

AU - Lingvay, Ildiko

AU - Salinas, Karin

AU - McGavock, Jonathan M.

AU - Raskin, Philip

AU - Szczepaniak, Lidia S.

PY - 2007/7

Y1 - 2007/7

N2 - High levels of myocardial and hepatic triglyceride are common in obesity and type 2 diabetes. Monotherapy with thiazolidinedione agents reduces hepatic steatosis by up to 50% in patients with type 2 diabetes. It is not known if treatment with a thiazolidinedione added to insulin has a similar beneficial antisteatotic effect. The aim of our study was to determine whether the addition of pioglitazone to insulin treatment in patients with type 2 diabetes has antisteatotic action in the heart and the liver. Thirty-two patients were randomized to 6 months of treatment with insulin or insulin plus pioglitazone. In addition to blood tests, we evaluated myocardial and hepatic triglyceride content, as well as subcutaneous and visceral fat mass at the L2 level, by magnetic resonance spectroscopy and imaging, respectively. Despite weight and subcutaneous fat mass gain, hemoglobin A1c was significantly reduced by both treatments. Myocardial and hepatic triglyceride contents were reduced by the treatment with pioglitazone plus insulin (p = .02 and .03, respectively) but not by the treatment with insulin. Systolic and diastolic blood pressure and heart function remained unchanged in both groups. The addition of pioglitazone to insulin therapy reduced myocardial and hepatic steatosis, consistent with the reported ability of the thiazolidinedione agents to redistribute fat from nonadipose to subcutaneous adipose depots.

AB - High levels of myocardial and hepatic triglyceride are common in obesity and type 2 diabetes. Monotherapy with thiazolidinedione agents reduces hepatic steatosis by up to 50% in patients with type 2 diabetes. It is not known if treatment with a thiazolidinedione added to insulin has a similar beneficial antisteatotic effect. The aim of our study was to determine whether the addition of pioglitazone to insulin treatment in patients with type 2 diabetes has antisteatotic action in the heart and the liver. Thirty-two patients were randomized to 6 months of treatment with insulin or insulin plus pioglitazone. In addition to blood tests, we evaluated myocardial and hepatic triglyceride content, as well as subcutaneous and visceral fat mass at the L2 level, by magnetic resonance spectroscopy and imaging, respectively. Despite weight and subcutaneous fat mass gain, hemoglobin A1c was significantly reduced by both treatments. Myocardial and hepatic triglyceride contents were reduced by the treatment with pioglitazone plus insulin (p = .02 and .03, respectively) but not by the treatment with insulin. Systolic and diastolic blood pressure and heart function remained unchanged in both groups. The addition of pioglitazone to insulin therapy reduced myocardial and hepatic steatosis, consistent with the reported ability of the thiazolidinedione agents to redistribute fat from nonadipose to subcutaneous adipose depots.

KW - Myocardial and hepatic steatosis

KW - Pioglitazone/insulin therapy

KW - Type 2 diabetes

UR - http://www.scopus.com/inward/record.url?scp=35048878739&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=35048878739&partnerID=8YFLogxK

U2 - 10.2310/6650.2007.00003

DO - 10.2310/6650.2007.00003

M3 - Article

VL - 55

SP - 230

EP - 236

JO - Journal of Investigative Medicine

JF - Journal of Investigative Medicine

SN - 1081-5589

IS - 5

ER -