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Efficacy and Safety of Pioglitazone versus Glimepiride after Metformin and Alogliptin Combination Therapy: A Randomized, Open-Label, Multicenter, Parallel-Controlled Study
Jeong Mi Kim, Sang Soo Kim, Jong Ho Kim, Mi Kyung Kim, Tae Nyun Kim, Soon Hee Lee, Chang Won Lee, Ja Young Park, Eun Sook Kim, Kwang Jae Lee, Young Sik Choi, Duk Kyu Kim, In Joo Kim
Diabetes Metab J. 2020;44(1):67-77.   Published online July 11, 2019
DOI: https://doi.org/10.4093/dmj.2018.0274
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  • 8 Web of Science
  • 11 Crossref
AbstractAbstract PDFPubReader   
Background

There is limited information regarding the optimal third-line therapy for managing type 2 diabetes mellitus (T2DM) that is inadequately controlled using dual combination therapy. This study assessed the efficacy and safety of pioglitazone or glimepiride when added to metformin plus alogliptin treatment for T2DM.

Methods

This multicenter, randomized, active-controlled trial (ClinicalTrials.gov: NCT02426294) recruited 135 Korean patients with T2DM that was inadequately controlled using metformin plus alogliptin. The patients were then randomized to also receive pioglitazone (15 mg/day) or glimepiride (2 mg/day) for a 26-week period, with dose titration was permitted based on the investigator's judgement.

Results

Glycosylated hemoglobin levels exhibited similar significant decreases in both groups during the treatment period (pioglitazone: −0.81%, P<0.001; glimepiride: −1.05%, P<0.001). However, the pioglitazone-treated group exhibited significantly higher high density lipoprotein cholesterol levels (P<0.001) and significantly lower homeostatic model assessment of insulin resistance values (P<0.001). Relative to pioglitazone, adding glimepiride to metformin plus alogliptin markedly increased the risk of hypoglycemia (pioglitazone: 1/69 cases [1.45%], glimepiride: 14/66 cases [21.21%]; P<0.001).

Conclusion

Among patients with T2DM inadequately controlled using metformin plus alogliptin, the addition of pioglitazone provided comparable glycemic control and various benefits (improvements in lipid profiles, insulin resistance, and hypoglycemia risk) relative to the addition of glimepiride.

Citations

Citations to this article as recorded by  
  • Efficacy and Safety of Alogliptin-Pioglitazone Combination for Type 2 Diabetes Mellitus Poorly Controlled with Metformin: A Multicenter, Double-Blind Randomized Trial
    Ji-Yeon Park, Joonyub Lee, Yoon-Hee Choi, Kyung Wan Min, Kyung Ah Han, Kyu Jeung Ahn, Soo Lim, Young-Hyun Kim, Chul Woo Ahn, Kyung Mook Choi, Kun-Ho Yoon
    Diabetes & Metabolism Journal.2024; 48(5): 915.     CrossRef
  • Efficacy and Safety of Pioglitazone Add-on in Patients with Type 2 Diabetes Mellitus Inadequately Controlled with Metformin and Dapagliflozin: A Multicenter, Randomized, Double-blind, and Placebo-controlled Study
    Yun Kyung Cho, Kyung-Soo Kim, Byung-Wan Lee, Jun Hwa Hong, Jae Myung Yu, Soo Lim, Ye An Kim, Chang Beom Lee, Sang Soo Kim, Soo Heon Kwak, Woo Je Lee
    Clinical Therapeutics.2024; 46(9): 662.     CrossRef
  • Pioglitazone as Add-on Therapy in Patients with Type 2 Diabetes Mellitus Inadequately Controlled with Dapagliflozin and Metformin: Double-Blind, Randomized, Placebo-Controlled Trial
    Ji Hye Heo, Kyung Ah Han, Jun Hwa Hong, Hyun-Ae Seo, Eun-Gyoung Hong, Jae Myung Yu, Hye Seung Jung, Bong-Soo Cha
    Diabetes & Metabolism Journal.2024; 48(5): 937.     CrossRef
  • A Green Approach: Optimization of the UPLC Method Using DoE Software for Concurrent Quantification of Pioglitazone and Dapagliflozin in a SNEDDS Formulation for the Treatment of Diabetes
    Ehab M. Elzayat, Abdelrahman Y. Sherif, Mohamed W. Attwa, Mohammad A. Altamimi
    ACS Omega.2024;[Epub]     CrossRef
  • Cost-effectiveness and budget impact analysis of fixed combination of alogliptin and pioglitazone in the treatment of type 2 diabetes mellitus
    Yu.V. Strunina, N.A. Petunina
    Medical Technologies. Assessment and Choice.2023; (3): 70.     CrossRef
  • Pioglitazone-Enhanced Brown Fat Whitening Contributes to Weight Gain in Diet-Induced Obese Mice
    Piaojian Yu, Wei Wang, Wanrong Guo, Lidan Cheng, Zhiping Wan, Yanglei Cheng, Yunfeng Shen, Fen Xu
    Experimental and Clinical Endocrinology & Diabetes.2023; 131(11): 595.     CrossRef
  • Compliance with Cardiovascular Prevention Guidelines in Type 2 Diabetes Individuals in a Middle-Income Region: A Cross-Sectional Analysis
    Joaquim Barreto, Beatriz Luchiari, Vaneza L. W. Wolf, Isabella Bonilha, Ticiane G. Bovi, Barbara S. Assato, Ikaro Breder, Sheila T. Kimura-Medorima, Daniel B. Munhoz, Thiago Quinaglia, Otavio R. Coelho-Filho, Luiz Sergio F. Carvalho, Wilson Nadruz, Andrei
    Diagnostics.2022; 12(4): 814.     CrossRef
  • Effects of Glimepiride Combined with Recombinant Human Insulin Injection on Serum IGF-1, VEGF and TRACP-5b Oxidative Stress Levels in Patients with Type 2 Diabetes Mellitus
    Xue Chen, Sheng Kang, Zeqing Bao, Ciara Hughes
    Evidence-Based Complementary and Alternative Medicine.2022; 2022: 1.     CrossRef
  • Glycaemic control with add‐on thiazolidinedione or a sodium‐glucose co‐transporter‐2 inhibitor in patients with type 2 diabetes after the failure of an oral triple antidiabetic regimen: A 24‐week, randomized controlled trial
    Jaehyun Bae, Ji Hye Huh, Minyoung Lee, Yong‐Ho Lee, Byung‐Wan Lee
    Diabetes, Obesity and Metabolism.2021; 23(2): 609.     CrossRef
  • Development and validation of a sensitive LC-MS/MS method for pioglitazone: application towards pharmacokinetic and tissue distribution study in rats
    Kusuma Kumari G., Praveen Thaggikuppe Krishnamurthy, Ravi Kiran Ammu V. V. V., Kurawattimath Vishwanath, S. T. Narenderan, B. Babu, Nagappan Krishnaveni
    RSC Advances.2021; 11(19): 11437.     CrossRef
  • Compliance with Cardiovascular Prevention Guidelines in Individuals with Type 2 Diabetes in a Middle-Income Region: Cross-Sectional Analysis
    Joaquim Barreto, Beatriz Luchiari, Vaneza Lira W. Wolf, Isabella Bonilha, Ticiane G. Bovi, Barbara S. Assato, Ikaro Breder, Sheila T. Kimura-Medorima, Daniel B. Munhoz, Thiago Quinaglia, Otavio R. Coelho-Filho, Luiz Sérgio Fernandes de Carvalho, Wilson Na
    SSRN Electronic Journal .2021;[Epub]     CrossRef
Complications
Prevalence and Risk Factors of Gastroesophageal Reflux Disease in Patients with Type 2 Diabetes Mellitus
Jun Ouk Ha, Tae Hee Lee, Chang Won Lee, Ja Young Park, Seong Ho Choi, Hee Seung Park, Jae Seung Lee, Seung Heon Lee, Eun Hee Seo, Young Hwan Kim, Young Woo Kang
Diabetes Metab J. 2016;40(4):297-307.   Published online June 8, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.4.297
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  • 8 Web of Science
  • 10 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   
Background

Gastrointestinal symptoms are common in patients with type 2 diabetes mellitus (T2DM). The prevalence of gastroesophageal reflux disease (GERD) in Korea appears to be increasing. Some studies have shown that T2DM is a risk factor for symptomatic GERD. However, this possibility is still debated, and the pathogenesis of GERD in T2DM is not yet fully understood. The aim of this study was to analyze the prevalence and risk factors (including autonomic neuropathy) of GERD in patients with T2DM.

Methods

This cross-sectional case-control study enrolled T2DM patients (n=258) and healthy controls (n=184). All participants underwent physical examinations and laboratory tests. We evaluated medical records and long-term diabetes complications, including peripheral and autonomic neuropathy in patients with T2DM. Esophagogastroduodenoscopy was performed in all patients. The Los Angeles (LA) classification was used to grade GERD. GERD was defined as LA grade A (or higher) or minimal change with GERD symptoms. GERD symptoms were examined using a frequency scale. Data were expressed as mean±standard error. Independent t-tests or chi-square tests were used to make comparisons between groups.

Results

The prevalence of GERD (32.6% vs. 35.9%, P=0.266) and GERD symptoms (58.8% vs. 59.2%, P=0.503) was not significantly different between T2DM patients and controls. We found no significant differences between T2DM patients with GERD and T2DM patients without GERD with respect to diabetic complications, including autonomic neuropathy, peripheral neuropathy, duration of DM, and glucose control.

Conclusion

The prevalence of GERD in patients with T2DM showed no difference from that of controls. GERD was also not associated with peripheral and cardiovascular autonomic neuropathy, age, or duration of DM in patients with T2DM.

Citations

Citations to this article as recorded by  
  • Gastroesophageal reflux disease influences blood pressure components, lipid profile and cardiovascular diseases: Evidence from a Mendelian randomization study
    Qiang Wu, Changjing He, Wanzhong Huang, Chaoqun Song, Xin Hao, Qing Zeng, Dazhi Lan, Qiang Su
    Journal of Translational Internal Medicine.2024; 12(5): 510.     CrossRef
  • Ураження органів травлення при цукровому діабеті
    M.O. Borovets , О.М. Radchenko , Kh.A. Moskva , O.Yo. Komarytsya , A.M. Urbanovych
    Endokrynologia.2023; 28(3): 270.     CrossRef
  • Metabolic effects of bariatric surgery on patients with type 2 diabetes: a population-based study
    Erman O. Akpinar, Ronald S.L. Liem, Simon W. Nienhuijs, Jan Willem M. Greve, Perla J. Marang-van de Mheen, L.M. de Brauw, S.M.M. de Castro, S.L. Damen, A. Demirkiran, M. Dunkelgrun, I.F. Faneyte, G. van ‘t Hof, I.M.C. Janssen, R.A. Klaassen, E.A.G.L. Laga
    Surgery for Obesity and Related Diseases.2021; 17(7): 1349.     CrossRef
  • The effect of proton pump inhibitors on glycaemic control in diabetic patients
    Muhammad Ali Rajput, Fizzah Ali, Tabassum Zehra, Shahid Zafar, Gunesh Kumar
    Journal of Taibah University Medical Sciences.2020; 15(3): 218.     CrossRef
  • Prediabetes and gastrointestinal (GI) symptoms; a cross-sectional study
    Akram Ghadiri-Anari, Somaye Gholami, Fariba Zolfaghari, Nasim Namiranian
    Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2019; 13(1): 844.     CrossRef
  • Gastrointestinal Symptoms in Diabetes: Prevalence, Assessment, Pathogenesis, and Management
    Yang T. Du, Christopher K. Rayner, Karen L. Jones, Nicholas J. Talley, Michael Horowitz
    Diabetes Care.2018; 41(3): 627.     CrossRef
  • Features of Endoscopic Changes in Gastroesophageal Reflux Disease in Patients with Type II Diabetes Mellitus
    Ye. S. Sirchak, M. P. Stan, Yo. I. Pichkar, V. V. Vajs
    Ukraïnsʹkij žurnal medicini, bìologìï ta sportu.2018; 3(5): 166.     CrossRef
  • Prevalence and Correlates of Gastroesophageal Reflux Disease in Southern Iran: Pars Cohort Study
    Zohre Khodamoradi, Abdullah Gandomkar, Hossein Poustchi, Alireza Salehi, Mohammad Hadi Imanieh, Arash Etemadi, Reza Malekzadeh
    Middle East Journal of Digestive Diseases.2017; 9(3): 129.     CrossRef
  • Letter: Prevalence and Risk Factors of Gastroesophageal Reflux Disease in Patients with Type 2 Diabetes Mellitus (Diabetes Metab J2016;40:297-307)
    Dongwon Yi
    Diabetes & Metabolism Journal.2016; 40(5): 418.     CrossRef
  • Response: Prevalence and Risk Factors of Gastroesophageal Reflux Disease in Patients with Type 2 Diabetes Mellitus (Diabetes Metab J2016;40:297-307)
    Jun Ouk Ha, Tae Hee Lee, Chang Won Lee
    Diabetes & Metabolism Journal.2016; 40(5): 420.     CrossRef
Current Status of Prescription in Type 2 Diabetic Patients from General Hospitals in Busan
Ji Hye Suk, Chang Won Lee, Sung Pyo Son, Min Cheol Kim, Jun Hyeob Ahn, Kwang Jae Lee, Ja Young Park, Sun Hye Shin, Min Jeong Kwon, Sang Soo Kim, Bo Hyun Kim, Soon Hee Lee, Jeong Hyun Park, In Joo Kim
Diabetes Metab J. 2014;38(3):230-239.   Published online June 17, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.3.230
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AbstractAbstract PDFPubReader   
Background

Data regarding the prescription status of individuals with diabetes are limited. This study was an analysis of participants from the relationship between cardiovascular disease and brachial-ankle pulse wave velocity in patients with type 2 diabetes (REBOUND) Study, which was a prospective multicenter cohort study recruited from eight general hospitals in Busan, Korea. We performed this study to investigate the current status of prescription in Korean type 2 diabetic patients.

Methods

Type 2 diabetic patients aged 30 years or more were recruited and data were collected for demographics, medical history, medications, blood pressure, and laboratory tests.

Results

Three thousands and fifty-eight type 2 diabetic patients were recruited. Mean age, duration of diabetes, and HbA1c were 59 years, 7.6 years, and 7.2%, respectively. Prevalence of hypertension was 66%. Overall, 7.3% of patients were treated with diet and exercise only, 68.2% with oral hypoglycemic agents (OHAs) only, 5.3% with insulin only, and 19.2% with both insulin and OHA. The percentage of patients using antihypertensive, antidyslipidemic, antiplatelet agents was similar as about 60%. The prevalence of statins and aspirin users was 52% and 32%, respectively.

Conclusion

In our study, two thirds of type 2 diabetic patients were treated with OHA only, and one fifth with insulin plus OHA, and 5% with insulin only. More than half of the patients were using each of antihypertensive, antidyslipidemic, or antiplatelet agents. About a half of the patients were treated with statins and one third were treated with aspirin.

Citations

Citations to this article as recorded by  
  • A double‐blind, Randomized controlled trial on glucose‐lowering EFfects and safety of adding 0.25 or 0.5 mg lobeglitazone in type 2 diabetes patients with INadequate control on metformin and dipeptidyl peptidase‐4 inhibitor therapy: REFIND study
    Soree Ryang, Sang Soo Kim, Ji Cheol Bae, Ji Min Han, Su Kyoung Kwon, Young Il Kim, Il Seong Nam‐Goong, Eun Sook Kim, Mi‐kyung Kim, Chang Won Lee, Soyeon Yoo, Gwanpyo Koh, Min Jeong Kwon, Jeong Hyun Park, In Joo Kim
    Diabetes, Obesity and Metabolism.2022; 24(9): 1800.     CrossRef
  • Arterial stiffness is an independent predictor for risk of mortality in patients with type 2 diabetes mellitus: the REBOUND study
    Jeong Mi Kim, Sang Soo Kim, In Joo Kim, Jong Ho Kim, Bo Hyun Kim, Mi Kyung Kim, Soon Hee Lee, Chang Won Lee, Min Chul Kim, Jun Hyeob Ahn, Jinmi Kim
    Cardiovascular Diabetology.2020;[Epub]     CrossRef
  • Efficacy and Safety of Pioglitazone versus Glimepiride after Metformin and Alogliptin Combination Therapy: A Randomized, Open-Label, Multicenter, Parallel-Controlled Study
    Jeong Mi Kim, Sang Soo Kim, Jong Ho Kim, Mi Kyung Kim, Tae Nyun Kim, Soon Hee Lee, Chang Won Lee, Ja Young Park, Eun Sook Kim, Kwang Jae Lee, Young Sik Choi, Duk Kyu Kim, In Joo Kim
    Diabetes & Metabolism Journal.2020; 44(1): 67.     CrossRef
  • Efficacy and safety of sitagliptin/metformin fixed‐dose combination compared with glimepiride in patients with type 2 diabetes: A multicenter randomized double‐blind study
    Sang Soo Kim, In Joo Kim, Kwang Jae Lee, Jeong Hyun Park, Young Il Kim, Young Sil Lee, Sung Chang Chung, Sang Jin Lee
    Journal of Diabetes.2017; 9(4): 412.     CrossRef
  • Arterial Stiffness Is More Associated with Albuminuria than Decreased Glomerular Filtration Rate in Patients with Type 2 Diabetes Mellitus: The REBOUND Study
    Jong Ho Kim, Sang Soo Kim, In Joo Kim, Bo Hyun Kim, Ja Young Park, Chang Won Lee, Ji Hye Suk, Sun Hae Shin, Sung Pyo Son, Min Chul Kim, Jun Hyeob Ahn, Kwang Jae Lee, Min Jung Kwon, Soon Hee Lee, Jeong Hyun Park
    Journal of Diabetes Research.2017; 2017: 1.     CrossRef
  • Insulin therapy for adult patients with type 2 diabetes mellitus: a position statement of the Korean Diabetes Association, 2017
    Byung-Wan Lee, Jin Hwa Kim, Seung-Hyun Ko, Kyu Yeon Hur, Nan-Hee Kim, Sang Youl Rhee, Hyun Jin Kim, Min Kyong Moon, Seok-O Park, Kyung Mook Choi
    The Korean Journal of Internal Medicine.2017; 32(6): 967.     CrossRef
  • Insulin Therapy for Adult Patients with Type 2 Diabetes Mellitus: A Position Statement of the Korean Diabetes Association, 2017
    Byung-Wan Lee, Jin Hwa Kim, Seung-Hyun Ko, Kyu-Yeon Hur, Nan-Hee Kim, Sang Youl Rhee, Hyun Jin Kim, Min Kyong Moon, Seok-O Park, Kyung Mook Choi
    Diabetes & Metabolism Journal.2017; 41(5): 367.     CrossRef
  • Reduction of Sulfonylurea with the Initiation of Basal Insulin in Patients with Inadequately Controlled Type 2 Diabetes Mellitus Undergoing Long-Term Sulfonylurea-Based Treatment
    Yeoree Yang, Jeong-Ah Shin, Hae Kyung Yang, Seung-Hwan Lee, Seung-Hyun Ko, Yu-Bae Ahn, Kun-Ho Yoon, Jae-Hyoung Cho
    Diabetes & Metabolism Journal.2016; 40(6): 454.     CrossRef
  • Comparison of Vildagliptin and Pioglitazone in Korean Patients with Type 2 Diabetes Inadequately Controlled with Metformin
    Jong Ho Kim, Sang Soo Kim, Hong Sun Baek, In Kyu Lee, Dong Jin Chung, Ho Sang Sohn, Hak Yeon Bae, Mi Kyung Kim, Jeong Hyun Park, Young Sik Choi, Young Il Kim, Jong Ryeal Hahm, Chang Won Lee, Sung Rae Jo, Mi Kyung Park, Kwang Jae Lee, In Joo Kim
    Diabetes & Metabolism Journal.2016; 40(3): 230.     CrossRef
Relationships between Brachial-Ankle Pulse Wave Velocity and Peripheral Neuropathy in Type 2 Diabetes
Byung Kil Ha, Bong Gun Kim, Dong Hyun Kim, Soon Il Lee, Soon Myung Jung, Ja Young Park, Chang Won Lee, Sang Soo Kim, Bo Hyun Kim, In Ju Kim
Diabetes Metab J. 2012;36(6):443-451.   Published online December 12, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.6.443
  • 5,643 View
  • 45 Download
  • 17 Crossref
AbstractAbstract PDFPubReader   
Background

Brachial-ankle pulse wave velocity (baPWV) is known to be a good surrogate marker of clinical atherosclerosis. Atherosclerosis is a major predictor for developing neuropathy. The goal of this study was to determine the relationship between baPWV and diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes.

Methods

A retrospective cross-sectional study was conducted involving 692 patients with type 2 diabetes. The correlation between increased baPWV and DPN, neurological symptoms, and neurological assessment was analyzed. DPN was examined using the total symptom score (TSS), ankle reflexes, the vibration test, and the 10-g monofilament test. DPN was defined as TSS ≥2 and an abnormal neurological assessment. Data were expressed as means±standard deviation for normally distributed data and as median (interquartile range) for non-normally distributed data. Independent t-tests or chi-square tests were used to make comparisons between groups, and a multiple logistic regression test was used to evaluate independent predictors of DPN. The Mantel-Haenszel chi-square test was used to adjust for age.

Results

Patients with DPN had higher baPWV and systolic blood pressure, and were more likely to be older and female, when compared to the control group. According to univariate analysis of risk factors for DPN, the odds ratio of the baPWV ≥1,600 cm/sec was 1.611 (95% confidence interval [CI], 1.072 to 2.422; P=0.021) and the odds ratio in female was 1.816 (95% CI, 1.195 to 2.760; P=0.005).

Conclusion

Increased baPWV was significantly correlated with peripheral neuropathy in patients with type 2 diabetes.

Citations

Citations to this article as recorded by  
  • Factors Affecting Arterial Stiffness and Brachial-Ankle Pulse Wave Velocity in Patients With Type 2 Diabetes
    Tomoki Furuya, Shinji Kitahama, Yuma Tamura, Susumu Ogawa, Yuki Nakatani, Takanori Yasu
    Cureus.2024;[Epub]     CrossRef
  • Association of arterial stiffness and neuropathy in diabetes: a systematic review and meta-analysis
    Angela Beros, John Sluyter, Robert Keith Rhodes Scragg
    BMJ Open Diabetes Research & Care.2023; 11(1): e003140.     CrossRef
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    Po-Lei Lee, Kuo-Wei Wang, Chen-Yuan Hsiao
    IEEE Sensors Journal.2023; 23(19): 23570.     CrossRef
  • Bilirubin is inversely related to diabetic peripheral neuropathy assessed by sural nerve conduction study
    Kentaro Abe, Yasutaka Maeda, Chitose Matsuzaki, Hisashi Yokomizo, Tomoaki Inoue, Noriyuki Sonoda, Yoshihiro Ogawa, Toyoshi Inoguchi
    Journal of Diabetes Investigation.2021; 12(11): 2028.     CrossRef
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    Bingwei Ma, Yao Chen, Chunjun Sheng, Peng Yang, Xingchun Wang, Shen Qu
    European Journal of Clinical Nutrition.2021; 75(11): 1645.     CrossRef
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    A. I. P. Wiegerinck, A. Thomsen, J. Hisdal, H. Kalvøy, C. Tronstad
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    Frontiers in Medicine.2020;[Epub]     CrossRef
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    Endocrinology and Metabolism.2018; 33(1): 88.     CrossRef
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    Hak Jun Kim, Young Hwan Park, Soo Hyun Kim
    Journal of the Korean Orthopaedic Association.2017; 52(4): 305.     CrossRef
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    Jun Ouk Ha, Tae Hee Lee, Chang Won Lee, Ja Young Park, Seong Ho Choi, Hee Seung Park, Jae Seung Lee, Seung Heon Lee, Eun Hee Seo, Young Hwan Kim, Young Woo Kang
    Diabetes & Metabolism Journal.2016; 40(4): 297.     CrossRef
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Cardio-Metabolic Features of Type 2 Diabetes Subjects Discordant in the Diagnosis of Metabolic Syndrome
Sa Rah Lee, Ying Han, Ja Won Kim, Ja Young Park, Ji Min Kim, Sunghwan Suh, Mi-Kyoung Park, Hye-Jeong Lee, Duk Kyu Kim
Diabetes Metab J. 2012;36(5):357-363.   Published online October 18, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.5.357
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AbstractAbstract PDFPubReader   
Background

The aim of this study is to investigate the cardio-metabolic parameters and surrogate markers of insulin resistance in a discordant group of type 2 diabetes (T2DM) subjects who satisfy the Adults Treatment Panel (ATP) III criteria, but not the International Diabetes Federation (IDF) criteria, for metabolic syndrome (MetS).

Methods

We assessed the prevalence of MetS in T2DM subjects (n=167) who were selected from subjects registered at the diabetes center of Dong-A University Medical Center. We used the ATP III criteria and the IDF criteria for the diagnosis of MetS and sorted the subjects into 2 MetS groups: one group diagnosed per ATP III criteria (MetSa) and one diagnosed per IDF criteria (MetSi). We then compared the clinical characteristics, metabolic parameters (homeostasis model assessment of insulin resistance, aspartate aminotransferase, alanine aminotransferase, and uric acid values) and co-morbidities (prevalence of microalbuminuria, fatty liver, and cardiovascular disease) between the MetSa, MetSi, and discordant MetS groups.

Results

The prevalence of MetS in the MetSa group (73.6%) was higher than in the MetSi group (62.2%). The MetS prevalence in the discordant group was 11.4%. The discordant group showed no significant differences in clinical characteristics (except waist circumference and body mass index), metabolic parameters, or prevalence of co-morbidities, as compared with subjects with MetS by both criteria.

Conclusion

In this study, cardio-metabolic features of the subjects diagnosed with MetS using ATP III criteria, but not IDF criteria, are not significantly different from those of subjects diagnosed with MetS using both criteria.

Citations

Citations to this article as recorded by  
  • Clinical analysis of the relationship between cystatin C and metabolic syndrome in the elderly
    Ping Liu, Shujian Sui, Dongling Xu, Xiaowei Xing, Caixia Liu
    Revista Portuguesa de Cardiologia.2014; 33(7-8): 411.     CrossRef
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    Tae Woo Jung, Hwan-Jin Hwang, Ho Cheol Hong, Hae Yoon Choi, Hye Jin Yoo, Sei Hyun Baik, Kyung Mook Choi
    Molecular and Cellular Endocrinology.2014; 391(1-2): 30.     CrossRef
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    Ping Liu, Shujian Sui, Dongling Xu, Xiaowei Xing, Caixia Liu
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Adiponectin Concentrations in Type 2 Diabetic Patients with or without Metabolic Syndrome.
Ja Young Park, Ja Won Kim, Ji Min Kim, Ying Han, Soo Kyung Park, Ji Young Mok, Mi Kyoung Park, Hye Jeong Lee, Duk Kyu Kim
Korean Diabetes J. 2008;32(3):224-235.   Published online June 1, 2008
DOI: https://doi.org/10.4093/kdj.2008.32.3.224
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AbstractAbstract PDF
BACKGROUND
Adipocytes produce several adipokines that modulate insulin action as well as glucose and lipid metabolism. The aim of this study was to evaluate the relationship between serum adiponectin concentrations and metabolic syndrome (MS) in patients with type 2 diabetes mellitus. METHODS: This study included 127 type 2 diabetic patients (males 63, females 64). The subjects were divided into two groups as with or without metabolic syndrome (MS(+) or MS(-)). The MS was diagnosed by International Diabetes Federation. Serum adiponectin, leptin, fasting plasma insulin, glucose, glycated hemoglobin, lipid profile, white blood corpuscle (WBC), aspartate aminotransferase (AST), alanine aminotransferase (ALT), uric acid and C-reactive protein (CRP) were examined. RESULTS: Serum adiponectin concentrations were significantly lower in MS(+) than MS(-) (4.8 +/- 2.4 microgram/mL vs 7.6 +/- 5.8 microgram/mL, 7.6 +/- 3.7 microgram/mL vs 11.5 +/- 7.2 microgram/mL, P < 0.05 in males and females). After adjustment for age and body mass index (BMI), in MS (+), the serum levels of adiponectin correlated positively with high density lipoprotein - cholesterol (HDL-C) and negatively with height, body weight, ALT and CRP. In MS(-), the serum levels of adiponectin correlated positively with HDL-C and negatively with diastolic blood pressure (DBP), triglyceride and CRP. By multiple regression analysis, no parameters were independently correlated with serum adiponectin concentrations in MS(+), while DBP and HDL-C were independently related to serum adiponectin concentrations in MS(-). CONCLUSION: Serum adiponectin concentrations were lower in type 2 diabetic patients with MS than without MS. There were no significant parameters related to decrease serum adiponectin concentrations in MS. But further study is needed to confirm this result.

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    Won Seon Jeon, Ji Woo Park, Namseok Lee, Se Eun Park, Eun Jung Rhee, Won Young Lee, Ki Won Oh, Sung Woo Park, Cheol-Young Park, Byung-Soo Youn
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    Woori Na, Cheongmin Sohn
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    The Korean Journal of Nutrition.2011; 44(4): 292.     CrossRef
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    Misung Kim, Juyoung Kim, Wookyung Bae, Sohye Kim, Yesong Lee, Woori Na, Cheongmin Sohn
    Korean Journal of Community Nutrition.2011; 16(1): 51.     CrossRef
  • Prevalence of Pancreatic Cancer in Diabetics and Clinical Characteristics of Diabetes-associated with Pancreatic Cancer - Comparison between Diabetes with and without Pancreatic Cancer -
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    The Korean Journal of Gastroenterology.2009; 54(3): 167.     CrossRef
Prevention of Diabetes by Fenofibrate in OLETF Rats: Hepatic Mechanism for Reducing Visceral Adiposity.
Hye Jeong Lee, Mi Kyoung Park, Kyung Il Lee, Young Jun An, Ji Min Kim, Ja Young Park, Young Han, Sook Hee Hong, Sun Seob Choi, Young Hyun Yoo, Joon Duk Suh, Duk Kyu Kim
Korean Diabetes J. 2007;31(1):63-74.   Published online January 1, 2007
DOI: https://doi.org/10.4093/jkda.2007.31.1.63
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AbstractAbstract PDF
BACKGROUND
The aim of this study is to evaluate the hepatic mechanism of fenofibrate that has the diabetes protective action in rats. METHODS: We chose OLETF rats and divided them into three groups. Fenofibrate (DF) group was fed with diet and fenofibrate (300 mg/kg/day). Paired feeding (Dd) group and free diet (DD) group were fed with diet. After 36 weeks of treatment, all the rats were sacrificed. RESULTS: The fasting blood glucose level of DF group (8.5 +/- 0.9 mmol/L) showed normal. The fasting blood glucose level of Dd group (22.4 +/- 3.0 mmol/L) and DD group (16.9 +/- 3.7 mmol/L) showed significantly increased than that of DF group (P < 0.01, respectively). The body weight, visceral adipose tissue and subcutaneous adipose tissue of DF group were significantly decreased compared to those of Dd and DD groups (P < 0.01, P < 0.05, P < 0.05). DF group showed significantly increased state-3 respiration rate, ATP synthetic activity, state-4 respiration rate and their blood beta-keton body levels than those of control groups (P < 0.01, respectively). DF group showed normal morphology of hepatocytes but DD and Dd groups showed hepatic steatosis with mitochondrial swellings. CONCLUSION: Chronic fenofibrate treatment prevents the development of diabetes in OLETF rats with inhibiting gain of body weight and abdominal adiposity. The hepatic mechanism for reducing visceral adiposity is that fenofibrate leads to increasing oxidative phosphorylation, uncoupling and ketogenesis as well as increasing beta-oxidation of fatty acids. Moreover, fenofibrate treatment prevents the development of hepatic steatosis.

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    Kyung-A Shin
    The Korean Journal of Clinical Laboratory Science.2016; 48(4): 304.     CrossRef
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    Jae-Joon Lee, Ah-Ra Kim, Hae-Choon Chang, Hae-Ok Jung, Myung-Yul Lee
    Journal of the Korean Society of Food Science and Nutrition.2012; 41(8): 1086.     CrossRef
  • Comparative analysis of fat and muscle proteins in fenofibratefed type II diabetic OLETF rats: the fenofibrate-dependent expression of PEBP or C11orf59 protein
    Jong-Ryeal Hahm, Jin-Sook Ahn, Hae-Sook Noh, Seon-Mi Baek, Ji-Hye Ha, Tae-Sik Jung, Yong-Jun An, Duk-Kyu Kim, Deok-Ryong Kim
    BMB Reports .2010; 43(5): 337.     CrossRef
  • Comparative analysis of fat and muscle proteins in fenofibratefed type II diabetic OLETF rats: the fenofibrate-dependent expression of PEBP or C11orf59 protein
    Jong-Ryeal Hahm, Jin-Sook Ahn, Hae-Sook Noh, Seon-Mi Baek, Ji-Hye Ha, Tae-Sik Jung, Yong-Jun An, Duk-Kyu Kim, Deok-Ryong Kim
    BMB Reports.2010; 43(5): 337.     CrossRef
Prevalence of Metabolic Syndrome in Type 2 DM Patients with Non-alcoholic Fatty Liver.
Ji Min Kim, Ja Young Park, Hyn Kyung Nam, Ja Won Kim, Su Kyung Park, Kyung Jin Nam, Mi Kyoung Park, Hye Jeong Lee, Duk Kyu Kim
Korean Diabetes J. 2006;30(6):442-449.   Published online November 1, 2006
DOI: https://doi.org/10.4093/jkda.2006.30.6.442
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AbstractAbstract PDF
BACKGROUND
Non-alcoholic fatty liver is rendered as one component of metabolic syndrome (MS). We evaluated the prevalence of MS as well as clinical and laboratory characteristics of Type 2 DM patients with non-alcoholic fatty liver. METHODS: Fatty liver group (n = 71) who showed significant fatty change by ultrasonography and age, sex matched control group (n = 40) were studied retrospectively. We compared demographic and laboratory findings and prevalence of MS by modified WHO criteria and new IDF criteria between both groups. RESULTS: There were no significant difference in age, DM duration, BMI, prevalence of hypertension, coronary artery disease, CVA, diabetic retinopathy, neuropathy, nephropathy between both groups. In fatty liver group, the plasma level of FBS, TG, ALT, total protein, albumin and GGT were significantly higher than those of control group (P = 0.033, P = 0.000, P = 0.002, P = 0.008, P = 0.003, P = 0.001). The plasma levels of HDL-C in fatty liver group were significantly lower than those of control group (P = 0.013). The plasma level of FBS, FFA, TG, total protein, albumin, ALT, HOMA(IR) and BMI were significantly related to the severity of fatty liver. The prevalence of MS in fatty liver group was significantly higher than that of control group by modified WHO criteria (P = 0.001) or new IDF criteria (P = 0.036). CONCLUSION: Type 2 DM patients with nonalcoholic fatty liver frequently accompanied the metabolic syndrome. They showed nonspecific changes in the liver function tests.

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  • Cardio-Metabolic Features of Type 2 Diabetes Subjects Discordant in the Diagnosis of Metabolic Syndrome
    Sa Rah Lee, Ying Han, Ja Won Kim, Ja Young Park, Ji Min Kim, Sunghwan Suh, Mi-Kyoung Park, Hye-Jeong Lee, Duk Kyu Kim
    Diabetes & Metabolism Journal.2012; 36(5): 357.     CrossRef
  • Metabolic Syndrome and Serum Alanine Aminotransferase Levels in Korean Adults : The Third Korea National Health and Nutrition Examination Survey (KNHANES III), 2005.
    Mi Ah Han, So Yeon Ryu, Jong Park, Myung Geun Kang, Ki Soon Kim
    Korean Journal of Epidemiology.2008; 30(1): 25.     CrossRef

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