Pioglitazone improves the cardiovascular profile in patients with uncomplicated systemic lupus erythematosus: a double-blind randomized clinical trial.
Lupus
; 21(1): 27-35, 2012 Jan.
Article
en En
| MEDLINE
| ID: mdl-21993383
ABSTRACT
OBJECTIVE:
We studied the effect of pioglitazone on insulin levels, inflammation markers, high-density lipoprotein (HDL) composition and subclasses distribution, in young women with uncomplicated systemic lupus erythematosus (SLE).METHODS:
This double-blind trial included 30 premenopausal women (30 ±8 years old) with SLE, who were randomized to pioglitazone (30 mg/day) or placebo treatment for 3 months. Plasma and HDL lipids were determined by colorimetric enzymatic assays, insulin by radioimmunometric assay, inflammation by immunonephelometry and HDL size and subclasses distribution by a native 4-30% polyacrylamide gradient gel electrophoresis.RESULTS:
Compared with placebo, pioglitazone significantly increased HDL-cholesterol plasma levels (14.2%), reduced fasting insulin plasma levels (23.6%) and the homeostasis model assessment-insulin resistance (31.7%). C-reactive protein (70.9%) and serum amyloid A (34.9%) were also significantly reduced with the pioglitazone use, whereas the HDL particle size was increased (8.80 nm vs. 8.95 nm; p = 0.044) by changes in the distribution of HDL(2b), HDL(3b), and HDL(3c) subclasses. The change in HDL size correlated with a rise in free and cholesterol-ester content in the HDL particles.CONCLUSION:
Pioglitazone significantly enhanced insulin sensitivity, reduced inflammation, and modified HDL characteristics, suggesting a potential beneficial effect of this drug in patients with SLE with a risk to develop cardiovascular disease. TRIAL REGISTRATION This trial is registered at ClinicalTrials.gov Protocol Registration System, with the number NCT01322308.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Enfermedades Cardiovasculares
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Tiazolidinedionas
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Hipoglucemiantes
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Lupus Eritematoso Sistémico
Tipo de estudio:
Clinical_trials
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Guideline
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Idioma:
En
Revista:
Lupus
Asunto de la revista:
REUMATOLOGIA
Año:
2012
Tipo del documento:
Article