Determinants of an optimal response to pioglitazone in terms of HDL-cholesterol

Yusuke Kabeya, Masuomi Tomita, Yoichiro Asai, Takeshi Katsuki, Yoichi Oikawa, Shu Meguro, Akira Shimada, Yoshihito Atsumi

Research output: Contribution to journalArticle

Abstract

Objective: The effect of pioglitazone on high-density lipoprotein cholesterol (HDL-C) has been attracting attention. However, there are limited data on the characteristics of patients who are likely to respond to pioglitazone in terms of the improvement in HDL-C levels (lipid responders). In the present study, the characteristics of lipid responders were investigated. Methods: Five hundred and sixty-three patients with type 2 diabetes who started pioglitazone treatment were followed for six months. They were divided into two groups according to the response to pioglitazone. Subjects whose HDL-C levels increased by 10% or more from the baseline were defined as lipid responders. The odds ratios (OR) for becoming lipid responders were calculated using logistic regression. Results: Significant patients' characteristics of lipid responders were age, HbA1c, HDL-C and low-density lipoprotein cholesterol (LDL-C), yielding adjusted ORs of 0.76 [95% confidence interval (CI) =0.61-0.93] for an increment of 10 years, 0.79 (95% CI=0.66-0.95) for an increment of 1 %, 0.83 (95% CI=0.72-0.96) for an increment of 10 mg/dL and 0.93 (95% CI=0.87-1.00) for an increment of 10 mg/dL, respectively. Patients with sulfonylurea treatment and those with both sulfonylurea and metformin treatment were less likely to become lipid responders than diet-treated patients with ORs of 0.32 (95% CI=0.15-0.69) and 0.41 (95% CI= 0.19-0.87), respectively. Conclusion: Pioglitazone could be beneficial especially for patients with young age, low HbA1c, low HDLC or low LDL-C levels at baseline in terms of the improvement in HDL-C levels. Use of sulfonylureas at baseline could attenuate the effect of pioglitazone on HDL-C.

Original languageEnglish
Pages (from-to)825-831
Number of pages7
JournalInternal Medicine
Volume50
Issue number8
DOIs
Publication statusPublished - 2011

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pioglitazone
HDL Cholesterol
Confidence Intervals
Lipids
LDL Cholesterol
Metformin
Type 2 Diabetes Mellitus
Therapeutics
Logistic Models
Odds Ratio
Diet

Keywords

  • Diabetes mellitus
  • High-density lipoprotein cholesterol
  • Pioglitazone
  • Responders

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Determinants of an optimal response to pioglitazone in terms of HDL-cholesterol. / Kabeya, Yusuke; Tomita, Masuomi; Asai, Yoichiro; Katsuki, Takeshi; Oikawa, Yoichi; Meguro, Shu; Shimada, Akira; Atsumi, Yoshihito.

In: Internal Medicine, Vol. 50, No. 8, 2011, p. 825-831.

Research output: Contribution to journalArticle

Kabeya, Y, Tomita, M, Asai, Y, Katsuki, T, Oikawa, Y, Meguro, S, Shimada, A & Atsumi, Y 2011, 'Determinants of an optimal response to pioglitazone in terms of HDL-cholesterol', Internal Medicine, vol. 50, no. 8, pp. 825-831. https://doi.org/10.2169/internalmedicine.50.4853
Kabeya, Yusuke ; Tomita, Masuomi ; Asai, Yoichiro ; Katsuki, Takeshi ; Oikawa, Yoichi ; Meguro, Shu ; Shimada, Akira ; Atsumi, Yoshihito. / Determinants of an optimal response to pioglitazone in terms of HDL-cholesterol. In: Internal Medicine. 2011 ; Vol. 50, No. 8. pp. 825-831.
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abstract = "Objective: The effect of pioglitazone on high-density lipoprotein cholesterol (HDL-C) has been attracting attention. However, there are limited data on the characteristics of patients who are likely to respond to pioglitazone in terms of the improvement in HDL-C levels (lipid responders). In the present study, the characteristics of lipid responders were investigated. Methods: Five hundred and sixty-three patients with type 2 diabetes who started pioglitazone treatment were followed for six months. They were divided into two groups according to the response to pioglitazone. Subjects whose HDL-C levels increased by 10{\%} or more from the baseline were defined as lipid responders. The odds ratios (OR) for becoming lipid responders were calculated using logistic regression. Results: Significant patients' characteristics of lipid responders were age, HbA1c, HDL-C and low-density lipoprotein cholesterol (LDL-C), yielding adjusted ORs of 0.76 [95{\%} confidence interval (CI) =0.61-0.93] for an increment of 10 years, 0.79 (95{\%} CI=0.66-0.95) for an increment of 1 {\%}, 0.83 (95{\%} CI=0.72-0.96) for an increment of 10 mg/dL and 0.93 (95{\%} CI=0.87-1.00) for an increment of 10 mg/dL, respectively. Patients with sulfonylurea treatment and those with both sulfonylurea and metformin treatment were less likely to become lipid responders than diet-treated patients with ORs of 0.32 (95{\%} CI=0.15-0.69) and 0.41 (95{\%} CI= 0.19-0.87), respectively. Conclusion: Pioglitazone could be beneficial especially for patients with young age, low HbA1c, low HDLC or low LDL-C levels at baseline in terms of the improvement in HDL-C levels. Use of sulfonylureas at baseline could attenuate the effect of pioglitazone on HDL-C.",
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AU - Shimada, Akira

AU - Atsumi, Yoshihito

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N2 - Objective: The effect of pioglitazone on high-density lipoprotein cholesterol (HDL-C) has been attracting attention. However, there are limited data on the characteristics of patients who are likely to respond to pioglitazone in terms of the improvement in HDL-C levels (lipid responders). In the present study, the characteristics of lipid responders were investigated. Methods: Five hundred and sixty-three patients with type 2 diabetes who started pioglitazone treatment were followed for six months. They were divided into two groups according to the response to pioglitazone. Subjects whose HDL-C levels increased by 10% or more from the baseline were defined as lipid responders. The odds ratios (OR) for becoming lipid responders were calculated using logistic regression. Results: Significant patients' characteristics of lipid responders were age, HbA1c, HDL-C and low-density lipoprotein cholesterol (LDL-C), yielding adjusted ORs of 0.76 [95% confidence interval (CI) =0.61-0.93] for an increment of 10 years, 0.79 (95% CI=0.66-0.95) for an increment of 1 %, 0.83 (95% CI=0.72-0.96) for an increment of 10 mg/dL and 0.93 (95% CI=0.87-1.00) for an increment of 10 mg/dL, respectively. Patients with sulfonylurea treatment and those with both sulfonylurea and metformin treatment were less likely to become lipid responders than diet-treated patients with ORs of 0.32 (95% CI=0.15-0.69) and 0.41 (95% CI= 0.19-0.87), respectively. Conclusion: Pioglitazone could be beneficial especially for patients with young age, low HbA1c, low HDLC or low LDL-C levels at baseline in terms of the improvement in HDL-C levels. Use of sulfonylureas at baseline could attenuate the effect of pioglitazone on HDL-C.

AB - Objective: The effect of pioglitazone on high-density lipoprotein cholesterol (HDL-C) has been attracting attention. However, there are limited data on the characteristics of patients who are likely to respond to pioglitazone in terms of the improvement in HDL-C levels (lipid responders). In the present study, the characteristics of lipid responders were investigated. Methods: Five hundred and sixty-three patients with type 2 diabetes who started pioglitazone treatment were followed for six months. They were divided into two groups according to the response to pioglitazone. Subjects whose HDL-C levels increased by 10% or more from the baseline were defined as lipid responders. The odds ratios (OR) for becoming lipid responders were calculated using logistic regression. Results: Significant patients' characteristics of lipid responders were age, HbA1c, HDL-C and low-density lipoprotein cholesterol (LDL-C), yielding adjusted ORs of 0.76 [95% confidence interval (CI) =0.61-0.93] for an increment of 10 years, 0.79 (95% CI=0.66-0.95) for an increment of 1 %, 0.83 (95% CI=0.72-0.96) for an increment of 10 mg/dL and 0.93 (95% CI=0.87-1.00) for an increment of 10 mg/dL, respectively. Patients with sulfonylurea treatment and those with both sulfonylurea and metformin treatment were less likely to become lipid responders than diet-treated patients with ORs of 0.32 (95% CI=0.15-0.69) and 0.41 (95% CI= 0.19-0.87), respectively. Conclusion: Pioglitazone could be beneficial especially for patients with young age, low HbA1c, low HDLC or low LDL-C levels at baseline in terms of the improvement in HDL-C levels. Use of sulfonylureas at baseline could attenuate the effect of pioglitazone on HDL-C.

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