Treatment with pioglitazone is associated with decreased preprandial ghrelin levels: A randomized clinical trial |
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| Institution: | 1. Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran;2. Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, VA, United States;3. Department of Toxicology and Pharmacology, Tehran University of Medical Sciences, Tehran, Iran;1. College of Pharmacy, Drug Research and Development Center, Daegu Catholic University, Gyeongsan 38430, Republic of Korea;2. Phutho College of Medicine and Pharmacy, Viettri City, Phutho Province 290000, Viet Nam;3. Department of Pharmaceutical Engineering, Inje University, Gyeongnam 50834, Republic of Korea;4. Laboratory of Immunobiology, School of Life Science and Biotechnology, College of Natural Sciences, Kyungpook National University, Daegu 39061, Republic of Korea;5. Faculty of Pharmacy, Hue University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam;6. Buon Ma Thuot University, Buon Ma Thuot City, Dak Lak Province 630000, Viet Nam;1. State Key Laboratory of Biocontrol and Guangdong Provincial Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, 510275, Guangzhou, China;2. Co-Innovation Center for Sustainable Forestry in Southern China, College of Biology and the Environment, Key Laboratory of State Forestry and Grassland Administration on Subtropical Forest Biodiversity Conservation, Nanjing Forestry University, 219937, Nanjing, China;3. Department of Biology Education, Chonnam National University, 61186, Gwangju, Republic of Korea;4. School of Life Sciences, Yunnan Normal University, 650001, Kunming, China;5. Faculty of Health and Life Sciences, INTI International University, 71800, Nilai, Malaysia;1. State Key Laboratory of Food Nutrition and Safety, Tianjin University of Science and Technology, Tianjin 300457, PR China;2. Key Laboratory of Food Nutrition and Safety, Ministry of Education, Tianjin University of Science and Technology, Tianjin 300457, PR China;3. College of Food Science and Biotechnology, Tianjin University of Science and Technology, Tianjin 300457, PR China;1. SNSB-Bavarian State Collection of Zoology, Münchhausenstraße 21, 81247 Munich, Germany;2. Australian Museum, 6 College Street, Sydney, NSW 2010, Australia;3. National Center for Biological Sciences, Tata Institute of Fundamental Research, Bengaluru 560065, India;4. 14, Résidence du Nouveau Parc, 78570 Andrésy, France;5. GeoBioCenter, Ludwig-Maximilians University, Munich, Germany |
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| Abstract: | The effects of metformin and pioglitazone on ghrelin, a physiologic regulator of appetite and food intake, have not been clearly established. In a randomized clinical trial, we randomly assigned 60 type 2 diabetic patients to either metformin (Group A; n = 30) or pioglitazone (Group B; n = 30) treatment groups. The groups were similar in their baseline characteristics. A standard fasting 75 g oral glucose tolerance test was performed at time zero before starting metformin or pioglitazone, and 3 months later. After 3 months of treatment, pioglitazone, but not metformin, was significantly associated with weight gain. Both groups experienced a significant reduction in fasting plasma glucose (p < 0.01), hemoglobin A1c (p < 0.01 in Group A and p < 0.05 in Group B), and insulin resistance (p < 0.01). The effect of metformin on preprandial ghrelin and its response to glucose challenge was not significant, while the pioglitazone group had a significant reduction in preprandial ghrelin levels after treatment (p < 0.05). The effect of pioglitazone on ghrelin was independent of changes in body weight, body mass index, glucose control, insulin resistance, and plasma insulin. In conclusion, treatment with pioglitazone is associated with a decrease in preprandial ghrelin levels and therefore, the weight gain and increased food intake related to pioglitazone use cannot be explained by its effects on ghrelin. The effect of pioglitazone on ghrelin is independent of changes in body weight, body mass index, plasma insulin, insulin resistance, or glucose control. |
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