Peroxisome Proliferator-Activated Receptor Gamma(PPAR-γ) Agonist Improves Endothelial Function in Diabetic Patients with Metabolic Syndrome: Pivotal Role of NOx and Inflammation

摘要

Background and Objectives Nitric oxide (NO) is thought to have antiatherosclerotic properties. On the other hand, NO activity is reduced in patients with metabolic syndrome, and endothelial dysfunction is an important early sign of atherosclerosis in patients with metabolic syndrome. The aim of this study was to investigate the effect of pioglitazone on the endothelial function in terms of the plasma NOx (combined nitrateitrite), the circulating inflammatory markers and the autonomic nervous system. Subjects and Methods We randomized 40 subjects with metabolic syndrome, and they were assigned to receive 15 mg of pioglitazone per day (the PIO group, n=21) during 12 weeks or they were placed in the placebo group (the PLA group, n=19). We estimate the endothelial function by performing vascular ultrasound. The plasma NOx levels, the levels of the inflammatory markers and the GRK2 levels were measured. Results After 12 weeks of therapy, flow mediated dilation (FMD) was improved in the PIO group (from 6.7±6% to 11.7±5%, respectively: p Conclusion Administration of PPAR-γ agonist in patients suffering with metabolic syndrome improves their endothelial function, enhances the production of NOx and reduces the proinflammatory markers, but this is not related to sympathetic regulation. PPAR-γ agonist may be able to modulate the progression of atherosclerosis.