MedWire News: Treatment with rosiglitazone has a more favorable impact on arterial stiffness than metformin in people with Type 2 diabetes, a small clinical study suggests.
The research was undertaken by Turkish researchers with the aim of evaluating the long-term impact of two insulin-sensitizing drugs – rosiglitazone, a thiazolidinedione, and metformin, a biguanide – on markers of diabetic vasculopathy.
In all, 50 drug-naïve patients with Type 2 diabetes were randomly assigned to receive rosiglitazone 4 mg/day, metformin 850 mg/day, or no drug therapy. All groups received standard advice on diet and physical activity.
The study lasted 52 weeks. Compared with baseline, patients in the rosiglitazone group showed a significant improvement in small-artery elasticity index, a measure of arterial stiffness. This parameter was unchanged in the other two groups.
Serum levels of matrix metalloproteinase-9 – a marker of inflammation – fell by 13.5% in the metformin group and by 27.2% in the rosiglitazone group, and both of these changes were significant versus baseline.
Serum levels of another inflammatory marker, monocyte chemoattractant protein-1, were unchanged in all three groups over the study period, however.
Commenting on their study, Sinem Kiyici (Uludag University, Bursa, Turkey) and co-authors say that rosiglitazone therapy had a favorable effect on vascular stiffness and inflammation whereas metformin impacted only inflammation. Interestingly, these effects appeared to be independent of glycemic control.
Writing in the journal Diabetes Research and Clinical Practice, the team concludes: “Since atherosclerotic vascular disease is the major cause of mortality and morbidity in patients with Type 2 diabetes mellitus… the effect of antidiabetic agents on arterial stiffness may be suggested when selecting therapy.”
However they add: “The clinical relevance of these data should be validated by additional prospective studies.”
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009
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