Pioglitazone reduces epicardial fat and improves diastolic function in patients with type 2 diabetes
Authors' conclusion
Pioglitazone reduced EAT and PAT areas and improved left ventricular (LV) diastolic function in T2DM. EAT and PAT are inversely correlated (PAT less strongly) with LV diastolic function and both EAT and PAT are inversely correlated with measures of insulin sensitivity.
Study context
- Population
- Patients with T2D without clinically manifest CVD and subjects with normal glucose tolerance
- Participants
- 12 vs 12
- Exposure
- Pioglitazone for 24 weeks in T2D; T2D vs normal glucose tolerance (NGT) at baseline
- T2DMn = 12
- NGTn = 12reference
- Outcome
- Effect of pioglitazone on epicardial (EAT) and paracardial adipose tissue (PAT), diastolic function and insulin sensitivity
- Follow-up
- 24 weeks
Methodological detailscardiac MRI, euglycaemic insulin clamp
- Cardiac MRI
- Euglycaemic insulin clamp
Main finding
As reported in the abstract
EAT area decrease after pioglitazone (P = 0.03)
9%
Paracardial adipose tissue (PAT) area decrease after pioglitazone (P = 0.09)
9%
Observational data: associations, not effects.
Further findings
Metabolic effects of pioglitazone · 24 weeks
- HbA1c reduction (P < 0.05)
- 0.9%
- HDL-C increase (P < 0.05)
- 7%
- Triacylglycerol reduction (P < 0.01)
- 42%
- Whole-body insulin-stimulated glucose uptake increase (P < 0.01)
- 71%
- Matsuda Index increase (P < 0.01)
- 100%
Left ventricular (LV) diastolic function (transmitral E/A, peak left ventricular flow rate (PLVFR)) · 24 weeks
- E/A and PLVFR reduced in T2DM vs NGT (P < 0.01)
- E/A and PLVFR increased after pioglitazone (P < 0.01-0.05)
Correlations at baseline
- Normalized PLVFR vs EAT (P = 0.03)
- r = −0.45
- Normalized PLVFR vs PAT (P = 0.16)
- r = −0.29
- E/A vs EAT (P = 0.006)
- r = −0.55
- E/A vs PAT (P = 0.05)
- r = −0.40
- EAT and PAT vs whole-body insulin-stimulated glucose uptake (P < 0.001)
- r = −0.68
- EAT and PAT vs Matsuda Index (P < 0.002)
- r = 0.99
Original publication
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