Abstract
Aim: In obese patients, the diet-induced weight loss markedly improves glucose tolerance with an increase in insulin sensitivity and a partial reduction of insulin secretion. The association with metformin treatment might potentiate the effect of diet alone. Methods: From patients admitted to our Nutritional Division for diet programme, we selected obese, non-diabetic, uncomplicated patients with age 18-65 years and body mass index 35-50 kg/m2 and studied the effects of a 6-month pharmacological treatment with either metformin (850 mg twice daily) or rosiglitazone (4 mg twice daily) on possible changes in body weight, fat mass, glucose and lipids metabolism. Results: A significant weight loss and reduction of fat mass was demonstrated with metformin (-9.7 ± 1.8 kg and -6.6 ± 1.1 kg) and also with rosiglitazone (-11.0 ± 1.9 kg and -7.2 ± 1.8 kg), without fluid retention in either treatment group. Rosiglitazone administration induced a significant decrease in glucose concentration (4.7 ± 0.1 vs. 4.4 ± 0.1 mmol/l, p <0.005) and insulin-circulating level (13.6 ± 1.5 vs. 8.0 ± 0.,7 μU/ml, p <0.005), an increase in insulin sensitivity as measured by homeostatic model assessment (HOMA) of insulin sensitivity (68.9 ± 8.8 vs. 109.9 ± 10.3, p <0.005) with a concomitant decrease in β-cell function as measured by HOMA of β-cell function (163.2 ± 16.1 vs. 127.4 ± 8.4, p <0.005). In contrast, metformin did not produce any significant effect on blood glucose concentration, insulin level and HOMA2 indexes. No adverse events were registered with pharmacological treatments. Conclusion: Our study shows that in severely obese, non-diabetic, hyperinsulinaemic patients undergoing a nutritional programme, rosiglitazone is more effective than metformin in producing favourable changes in fasting-based indexes of glucose metabolism, with a reduction of both insulin resistance and hyperinsulinaemia. In spite of previous studies reporting rosiglitazone-induced body weight gain, in our study the joint treatment with diet and rosiglitazone was accompanied by weight loss and fat mass reduction.
| Original language | English |
|---|---|
| Pages (from-to) | 460-467 |
| Number of pages | 8 |
| Journal | Diabetes, Obesity and Metabolism |
| Volume | 10 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Jun 2008 |
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Keywords
- β-cell function
- Insulin sensitivity
- Metformin
- Obesity
- Rosiglitazone
ASJC Scopus subject areas
- Internal Medicine
- Endocrinology
- Endocrinology, Diabetes and Metabolism
Cite this
Rosiglitazone is more effective than metformin in improving fasting indexes of glucose metabolism in severely obese, non-diabetic patients. / Brunani, Amelia; Caumo, A.; Graci, S.; Castagna, G.; Viberti, G.; Liuzzi, A.
In: Diabetes, Obesity and Metabolism, Vol. 10, No. 6, 06.2008, p. 460-467.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Rosiglitazone is more effective than metformin in improving fasting indexes of glucose metabolism in severely obese, non-diabetic patients
AU - Brunani, Amelia
AU - Caumo, A.
AU - Graci, S.
AU - Castagna, G.
AU - Viberti, G.
AU - Liuzzi, A.
PY - 2008/6
Y1 - 2008/6
N2 - Aim: In obese patients, the diet-induced weight loss markedly improves glucose tolerance with an increase in insulin sensitivity and a partial reduction of insulin secretion. The association with metformin treatment might potentiate the effect of diet alone. Methods: From patients admitted to our Nutritional Division for diet programme, we selected obese, non-diabetic, uncomplicated patients with age 18-65 years and body mass index 35-50 kg/m2 and studied the effects of a 6-month pharmacological treatment with either metformin (850 mg twice daily) or rosiglitazone (4 mg twice daily) on possible changes in body weight, fat mass, glucose and lipids metabolism. Results: A significant weight loss and reduction of fat mass was demonstrated with metformin (-9.7 ± 1.8 kg and -6.6 ± 1.1 kg) and also with rosiglitazone (-11.0 ± 1.9 kg and -7.2 ± 1.8 kg), without fluid retention in either treatment group. Rosiglitazone administration induced a significant decrease in glucose concentration (4.7 ± 0.1 vs. 4.4 ± 0.1 mmol/l, p <0.005) and insulin-circulating level (13.6 ± 1.5 vs. 8.0 ± 0.,7 μU/ml, p <0.005), an increase in insulin sensitivity as measured by homeostatic model assessment (HOMA) of insulin sensitivity (68.9 ± 8.8 vs. 109.9 ± 10.3, p <0.005) with a concomitant decrease in β-cell function as measured by HOMA of β-cell function (163.2 ± 16.1 vs. 127.4 ± 8.4, p <0.005). In contrast, metformin did not produce any significant effect on blood glucose concentration, insulin level and HOMA2 indexes. No adverse events were registered with pharmacological treatments. Conclusion: Our study shows that in severely obese, non-diabetic, hyperinsulinaemic patients undergoing a nutritional programme, rosiglitazone is more effective than metformin in producing favourable changes in fasting-based indexes of glucose metabolism, with a reduction of both insulin resistance and hyperinsulinaemia. In spite of previous studies reporting rosiglitazone-induced body weight gain, in our study the joint treatment with diet and rosiglitazone was accompanied by weight loss and fat mass reduction.
AB - Aim: In obese patients, the diet-induced weight loss markedly improves glucose tolerance with an increase in insulin sensitivity and a partial reduction of insulin secretion. The association with metformin treatment might potentiate the effect of diet alone. Methods: From patients admitted to our Nutritional Division for diet programme, we selected obese, non-diabetic, uncomplicated patients with age 18-65 years and body mass index 35-50 kg/m2 and studied the effects of a 6-month pharmacological treatment with either metformin (850 mg twice daily) or rosiglitazone (4 mg twice daily) on possible changes in body weight, fat mass, glucose and lipids metabolism. Results: A significant weight loss and reduction of fat mass was demonstrated with metformin (-9.7 ± 1.8 kg and -6.6 ± 1.1 kg) and also with rosiglitazone (-11.0 ± 1.9 kg and -7.2 ± 1.8 kg), without fluid retention in either treatment group. Rosiglitazone administration induced a significant decrease in glucose concentration (4.7 ± 0.1 vs. 4.4 ± 0.1 mmol/l, p <0.005) and insulin-circulating level (13.6 ± 1.5 vs. 8.0 ± 0.,7 μU/ml, p <0.005), an increase in insulin sensitivity as measured by homeostatic model assessment (HOMA) of insulin sensitivity (68.9 ± 8.8 vs. 109.9 ± 10.3, p <0.005) with a concomitant decrease in β-cell function as measured by HOMA of β-cell function (163.2 ± 16.1 vs. 127.4 ± 8.4, p <0.005). In contrast, metformin did not produce any significant effect on blood glucose concentration, insulin level and HOMA2 indexes. No adverse events were registered with pharmacological treatments. Conclusion: Our study shows that in severely obese, non-diabetic, hyperinsulinaemic patients undergoing a nutritional programme, rosiglitazone is more effective than metformin in producing favourable changes in fasting-based indexes of glucose metabolism, with a reduction of both insulin resistance and hyperinsulinaemia. In spite of previous studies reporting rosiglitazone-induced body weight gain, in our study the joint treatment with diet and rosiglitazone was accompanied by weight loss and fat mass reduction.
KW - β-cell function
KW - Insulin sensitivity
KW - Metformin
KW - Obesity
KW - Rosiglitazone
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UR - http://www.scopus.com/inward/citedby.url?scp=43149099908&partnerID=8YFLogxK
U2 - 10.1111/j.1463-1326.2007.00728.x
DO - 10.1111/j.1463-1326.2007.00728.x
M3 - Article
C2 - 17394563
AN - SCOPUS:43149099908
VL - 10
SP - 460
EP - 467
JO - Diabetes, Obesity and Metabolism
JF - Diabetes, Obesity and Metabolism
SN - 1462-8902
IS - 6
ER -