Vascular effects of improving metabolic control with metformin or rosiglitazone in Type 2 diabetes. (Articolo in rivista)

Type
Label
  • Vascular effects of improving metabolic control with metformin or rosiglitazone in Type 2 diabetes. (Articolo in rivista) (literal)
Anno
  • 2004-01-01T00:00:00+01:00 (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#doi
  • 10.2337/diacare.27.6.1349 (literal)
Alternative label
  • Natali A., Baldeweg S., Toschi E., Capaldo B., Barbaro D., Gastaldelli A., Yudkin J.S., Ferrannini E (2004)
    Vascular effects of improving metabolic control with metformin or rosiglitazone in Type 2 diabetes.
    in Diabetes care; American Diabetes Association, Alexandria (Stati Uniti d'America)
    (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#autori
  • Natali A., Baldeweg S., Toschi E., Capaldo B., Barbaro D., Gastaldelli A., Yudkin J.S., Ferrannini E (literal)
Pagina inizio
  • 1349 (literal)
Pagina fine
  • 1357 (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#url
  • http://www.ncbi.nlm.nih.gov/pubmed/15161787?dopt=Citation (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#numeroVolume
  • 27 (literal)
Rivista
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#pagineTotali
  • 9 (literal)
Note
  • ISI Web of Science (WOS) (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#affiliazioni
  • Univ Pisa, Dept Internal Med, Via Roma 67, I-56100 Pisa, Italy Univ Pisa, Dept Internal Med, I-56100 Pisa, Italy Univ Pisa, CNR, Inst Clin Physiol, I-56100 Pisa, Italy Livorno Gen Hosp, Livorno, Italy Univ Naples Federico 2, Dept Internal Med, Naples, Italy UCL, Dept Med, London, England (literal)
Titolo
  • Vascular effects of improving metabolic control with metformin or rosiglitazone in Type 2 diabetes. (literal)
Abstract
  • OBJECTIVE: The aim of this study was to test whether vascular reactivity is modified by improving metabolic control and peripheral insulin resistance in type 2 diabetes. RESEARCH DESIGN AND METHODS: In a randomized, double-blind design, we assigned 74 type 2 diabetic patients to rosiglitazone (8 mg/day), metformin (1,500 mg/day), or placebo treatment for 16 weeks and measured insulin sensitivity (euglycemic insulin clamp), ambulatory blood pressure, and forearm blood flow response to 1) intra-arterial acetylcholine (ACh), 2) intra-arterial nitroprusside, 3) the clamp, and 4) blockade of nitric oxide (NO) synthase. RESULTS: Compared with 25 nondiabetic subjects, patients had reduced insulin sensitivity (30 +/- 1 vs. 41 +/- 3 micromol. min(-1). kg fat-free mass(-1); P < 0.001) and reduced maximal response to ACh (586 +/- 42 vs. 883 +/- 81%; P < 0.001). Relative to placebo, 16 weeks of rosiglitazone and metformin similarly reduced fasting glucose (-2.3 +/- 0.5 and -2.3 +/- 0.5 mmol/l) and HbA(1c) (-1.2 +/- 0.3 and -1.6 +/- 0.3%). Insulin sensitivity increased with rosiglitazone (+6 +/- 3 micromol. min(-1). kg fat-free mass(-1); P < 0.01) but not with metformin or placebo. Ambulatory diastolic blood pressure fell consistently (-2 +/- 1 mmHg; P < 0.05) only in the rosiglitazone group. Nitroprusside dose response, clamp-induced vasodilatation, and NO blockade were not affected by either treatment. In contrast, the slope of the ACh dose response improved with rosiglitazone (+40% versus baseline, P < 0.05, +70% versus placebo, P < 0.005) but did not change with either metformin or placebo. This improvement in endothelium-dependent vasodilatation was accompanied by decrements in circulating levels of free fatty acids and tumor necrosis factor-alpha. CONCLUSIONS: At equivalent glycemic control, rosiglitazone, but not metformin, improves endothelium dependent vasodilatation and insulin sensitivity in type 2 diabetes. (literal)
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