Recent Longevity News for the seven days ending 11/19/08.  You should consult your doctor if you are taking any medications.

Vitamin D Can Alter Color Cancer Cells In Many Ways, Through One Pathway - Science Daily, 11/17/08 - "Vitamin D can tame the rogue cell by adjusting everything from its gene expression to its cytoskeleton" - See vitamin D at Amazon.com.

Physical Activity, Sleep May Cut Cancer Risk - WebMD, 11/17/08 - "Among the most physically active women younger than 65 -- women who reported getting about an hour a day of moderate physical activity -- cancer was 47% rarer for those who got at least seven hours of nightly sleep. Those findings held regardless of other cancer risk factors"

Does Growth Hormone Drug Slow Alzheimer's Disease? - Science Daily, 11/17/08 - "A new study shows that a drug that increases the release of growth hormone failed to slow the rate of progression of Alzheimer's disease in humans"

Men Who Take Aspirin Have Significantly Lower PSA Levels - Science Daily, 11/16/08 - "PSA levels were 9 percent lower in men taking aspirin (the NSAID most commonly used) compared with men who did not use aspirin"

Calcium May Only Protect Against Colorectal Cancer In Presence Of Magnesium - Science Daily, 11/16/08 - "supplementation of calcium only reduced the risk of adenoma recurrence if the ratio of calcium to magnesium was low and remained low during treatment. "The risk of colorectal cancer adenoma recurrence was reduced by 32 percent among those with baseline calcium to magnesium ratio below the median in comparison to no reduction for those above the median"

Vitamin C Lowers Levels Of Inflammation Biomarker Considered Predictor Of Heart Disease - Science Daily, 11/14/08 - "for people with elevated CRP levels, the amount of CRP reduction achieved by taking vitamin C supplements in this study is comparable to that in many other studies of cholesterol-lowering drugs called statins. They noted that several larger statin trials lowered CRP levels by about 0.2 milligrams per liter; in this latest study, vitamin C lowered CRP by 0.25 milligrams per liter" - See vitamin C products at Amazon.com.

Belly Fat Doubles Death Risk - WebMD, 11/12/08 - "Belly fat has been linked to an increased risk of heart disease and diabetes. Now an important new study links belly fat to early death ... Each 2-inch increase in waist circumference was associated with close to a 17% increase in mortality in men and a 13% increase in women"

Abstracts from this week's Doctor's Guide Nutrition/Dietetics plus abstracts from my RSS feeds (Click here for the journals, the PubMed ones at the top):

Cyanocobalamin May be Beneficial in the Treatment of Recurrent Aphthous Ulcers Even When Vitamin B12 Levels Are Normal - Am J Med Sci. 2008 Nov;336(5):379-382. - "recurrent aphthous ulcers (RAUs) ... vitamin B12 (cobalamin) ... cobalamin normal group (CNG) ... A significant increase in cobalamin levels was observed after cyanocobalamin treatment in both groups. A significant decrease in aphthous ulcer frequency was also concurrently observed. 96% of the patients showed good response to replacement treatment, 4% of the study population did not respond to the treatment ... Cyanocobalamin treatment maybe beneficial for patients with RAU even when serum cobalamin levels are normal. We suggest that higher serum cobalamin levels should be attained in patients with RAU for mucosal protection" - See vitamin B12 at Amazon.com.

Telmisartan improves insulin resistance in high renin nonmodulating salt-sensitive hypertensives - J Hypertens. 2008 Dec;26(12):2393-8 - "Nonmodulating (NMHT) is a high-renin subtype of salt sensitive hypertension, which additionally develops insulin resistance and oxidative stress. Conversely, modulating hypertensives (MHT) normally regulates renal hemodynamics after high sodium intake without metabolic impairment ... In NMHT, telmisartan, after 3 months treatment, significantly reduced fasting and 120 min insulinemia (fasting: 8.4 +/- 2, 120 min: 25 +/- 10 muU%; P < 0.01) compared either to basal values or ramipril treatment. Similarly, only in NMHT, compared with basal values and ramipril treatment, telmisartan improved the HOMA-IR index in both MHT (2.76 +/- 0.16 to 2.24 +/- 0.18, P < 0.05) and NMHT (from: 4.4 +/- 1 to 2.3 +/- 0.7) and triglyceride plasma levels (MHT: from 139 +/- 1.85 to 122 +/- 2.4 mg%, P < 0.05; NMHT: from: 223 +/- 12 to 146 +/- 10 mg%, P < 0.01). Finally, highly sensitive C-protein-reactive protein values were higher in NMHT (0.33 +/- 0.07 mg.dl) than in MHT (0.14 +/- 0.06 mg.dl; P < 0.01). Both treatments reduced highly sensitive C-protein-reactive protein in NMHT. (ramipril from 0.32 +/- 0.05 mg.dl to 0.26 +/- 0.06 m.dl (P < 0.05) and telmisartan from 0.34 +/- 0.05+/- to 0.20 +/- 0.05 mg.dl (P < 0.01). CONCLUSION: Our data suggest that the improvement of the insulin sensitivity by telmisartan, instead of a similar effect on blood pressure shown by both drugs, could be ascribed to the PPAR agonistic action of telmisartan. This opens an interesting therapeutic approach for patients with hypertension and altered glycemic metabolism"

Telmisartan prevents aneurysm progression in the rat by inhibiting proteolysis, apoptosis and inflammation - J Hypertens. 2008 Dec;26(12):2361-73 - "The angiotensin II type 1 receptor antagonist, telmisartan, prevents abdominal aortic aneurysm progression independently of blood pressure reduction by inhibiting proteolysis, apoptosis and inflammation in aortic tissue"

Grape seed extract induces cell cycle arrest and apoptosis in human colon carcinoma cells - Nutr Cancer. 2008;60 Suppl 1:2-11 - "control colorectal cancer (CRC) ... Grape seed extract (GSE) ... Our results show that irrespective of source, GSE strongly inhibits LoVo, HT29, and SW480 cell growth, with a G1 arrest in LoVo and HT29 cells but an S and/or G2/M arrest in SW480 cell cycle progression. GSE also induced Cip/p21 levels in all 3 cell lines. Furthermore, an induction of apoptosis was observed in all 3 cell lines by GSE. Taken together, our findings suggest that GSE could be an effective CAM agent against CRC possibly due to its strong growth inhibitory and apoptosis-inducing effects" - See grape seed extract at Amazon.com.

Angiotensin II type 2 receptor blockade increases bone mass - J Biol Chem. 2008 Nov 11 - "Treatment with AT2 receptor blocker significantly enhanced the levels of bone mass and this effect was based on the enhancement of osteoblastic activity as well as the suppression of osteoclastic activity in vivo" - That might be another good reason for telmisartan as a first line treatment for hypertension.  See telmisartan at OffshoreRx1.com.

Increased reverse T3 is associated with shorter survival in independently-living elderly. The Alsanut study - Eur J Endocrinol. 2008 Nov 10 - "rT3 was the only thyroid hormone associated with shorter survival" - Related topics:

• Wilson's Reverse T3 Dominance Syndrome - knoxintegrativemed.com - "However, when a person experiences prolonged stress, the adrenal glands respond by manufacturing a large amount of cortisol. Cortisol inhibits the conversion of T4 to T3 and favors the conversion of T4 to RT3. If stress is prolonged, a condition called Reverse T3 Dominance occurs and persists even after the stress passes and cortisol levels fall. Apparently, RT3 itself acts like cortisol and blocks the conversion of T4 to T3"

Effects of carnitine supplementation on flow-mediated dilation and vascular inflammatory responses to a high-fat meal in healthy young adults - Am J Cardiol. 2008 Nov 15;102(10):1413-7 - "flow-mediated dilation (FMD) ... these findings indicate that carnitine supplementation in healthy individuals improves postprandial FMD after a high-fat meal"

Neat Tech Stuff :

• Google Mobile App - This was just released for the iPhone.  See the video.  For example it recognizes your location and you can just say something like "show times" or "Chinese restaurant" and it does the search for you.

Health Focus (Actos (pioglitazone HCl)) - I threw this in so that people could read the pro and cons.  The big thing about pioglitazone is that it reduces the risk of progression to diabetes by 81% (metformin is only 31%) and diabetes is becoming almost epidemic.  :

Pioglitazone News & Research:

• See pioglitazone at OffshoreRx1.com.
• Actos (pioglitazone hydrochloride) - rxlist.com - "ACTOS improves glycemic control while reducing circulating insulin levels"
• Obesity and Fatty Liver disease - MedicineNet.com - "Doctors also are using medications to treat non alcoholic fatty liver disease. For example, insulin-sensitizing agents, such as the thiazolidinediones, pioglitazone (Actos) and rosiglitazone (Avandia), and metformin (Glucophage) not only help to control blood glucose in patients with diabetes, but they also improve enzyme levels in patients with non alcoholic fatty liver disease"
• Pioglitazone Improves Fatty Liver Disease in Nondiabetics - Medscape, 11/5/08
• Pioglitazone Cuts Risk of Progression to Diabetes - Clinical Psychiatry News, 7/08 - "People with impaired glucose tolerance were 81% less likely to develop type 2 diabetes over a 3-year period if treated with pioglitazone ... Patients were randomized to treatment with placebo or 30 mg/day pioglitazone. If the drug was tolerated after 1 month, the dose could be increased up to 45 mg/day" - Note: Diabetes runs in my family.  I've been taking pioglitazone for several years for prevention.  See pioglitazone at OffshoreRx1.com.
• Pioglitazone Prevents Conversion to Diabetes Among Insulin-Resistant Patients - Doctor's Guide, 6/11/08 - "Patients with impaired glucose tolerance treated with pioglitazone were able to stave off conversion to type 2 diabetes by 81% when compared with individuals who received placebo"
• Pioglitazone Reduces Conversion From Impaired Glucose Tolerance to Diabetes - Medscape, 6/8/08 - "There was a weight gain of 3.9 kg in the pioglitazone group vs about 0.8 kg in the placebo group ... Over a mean follow-up of 2.6 years, pioglitazone markedly decreased, by 81%, the conversion rate of IGT to type 2 diabetes. IGT individuals who had the worst level of beta cell function and who were the most insulin resistant were the individuals who were most likely to develop type 2 diabetes, whether they were in the pioglitazone group...or the placebo group. Pioglitazone was quite safe and quite efficacious"
• Pioglitazone Reduces Conversion From Impaired Glucose Tolerance to Diabetes - Medscape, 6/8/08 - "There was a weight gain of 3.9 kg in the pioglitazone group vs about 0.8 kg in the placebo group ... Over a mean follow-up of 2.6 years, pioglitazone markedly decreased, by 81%, the conversion rate of IGT to type 2 diabetes. IGT individuals who had the worst level of beta cell function and who were the most insulin resistant were the individuals who were most likely to develop type 2 diabetes, whether they were in the pioglitazone group...or the placebo group. Pioglitazone was quite safe and quite efficacious"
• Pioglitazone and cardiovascular risk. A comprehensive meta-analysis of randomized clinical trials - Diabetes Obes Metab. 2008 May 26 - "The use of pioglitazone does not appear to be harmful in terms of cardiovascular events and all-cause deaths"
• Rosiglitazone and pioglitazone similarly improve insulin sensitivity and secretion, glucose tolerance and adipocytokines in type 2 diabetic patients - Diabetes Obes Metab. 2008 May 12 - "Rosiglitazone and pioglitazone have similar beneficial effects on glycaemic control insulin sensitivity, insulin secretion and plasma adipocytokine levels. However, pioglitazone has a more beneficial effect on the plasma lipid profile than rosiglitazone"
• Pioglitazone May Prevent Progression of Atherosclerosis in Patients With Type 2 Diabetes - Doctor's Guide, 4/2/08 - "Two TZD agents are currently on the market -- pioglitazone and rosiglitazone. Both agents reduce inflammatory biomarkers, while pioglitazone also produces elevation of high-density lipoprotein cholesterol (HDL-C) and reduction of triglyceride levels ... Dr. Nissen said the findings of the PERISCOPE study support the conclusion that treatment with pioglitazone can prevent the progression of atherosclerosis in patients with type 2 diabetes during 18 months of treatment. These finding may have important implications for defining the optimal strategy for management of patients with type 2 diabetes and coronary atherosclerosis" - See pioglitazone at OffshoreRx1.com.
• Effects of pioglitazone on major adverse cardiovascular events in high-risk patients with type 2 diabetes: Results from PROspective pioglitAzone Clinical Trial In macro Vascular Events (PROactive 10) - Am Heart J. 2008 Apr;155(4):712-717 - "major adverse cardiovascular events (MACEs) ... At final visit, 257 (9.9%) pioglitazone-treated and 313 (11.9%) placebo-treated patients had a first event that contributed to the MACE1 end point (hazard ratio 0.82, 95% CI 0.70-0.97, P = .0201). There were statistically significant differences in favor of pioglitazone in 5 of the other MACE end points (P < .05) and a trend to benefit in the sixth (P = .052), with hazard ratios of 0.79 to 0.83 ... In patients with advanced type 2 diabetes at high risk for cardiovascular events, pioglitazone treatment resulted in significant risk reductions in MACE composite end points to 3 years"
• Thiazolidinediones May Act Against Psoriasis - Medscape, 3/26/08 - "The adjusted odds ratio for a first time diagnosis of psoriasis in current users of five or more prescriptions for thiazolidinediones was 0.33, as compared to no use. The adjusted odds ratio for metformin was 0.77" - See pioglitazone at OffshoreRx1.com.
• PROactive: Pioglitazone reduced many different definitions of MACE - theheart.org, 3/5/08 - "The main results, reported in 2005, showed a nonsignificant 10% reduction vs placebo in the study's primary end point of all macrovascular events (all-cause mortality, nonfatal MI [including silent infarction], stroke, ACS, cardiac intervention [CABG or PCI], leg revascularization, or amputation above the ankle). The secondary composite end point of all-cause death, MI, and stroke was reduced by a significant 16%. But the authors have previously attracted criticism for focusing on this one secondary end point when the primary end point of the study was not significant ... The main results, reported in 2005, showed a nonsignificant 10% reduction vs placebo in the study's primary end point of all macrovascular events (all-cause mortality, nonfatal MI [including silent infarction], stroke, ACS, cardiac intervention [CABG or PCI], leg revascularization, or amputation above the ankle). The secondary composite end point of all-cause death, MI, and stroke was reduced by a significant 16%. But the authors have previously attracted criticism for focusing on this one secondary end point when the primary end point of the study was not significant ... "Because there was some controversy about our secondary end point, we decided to apply the PROactive data to other definitions of MACE often used in major clinical trials to see whether the results still held irrespective of which components of the MACE end point were included. We found a consistent reduction in events with all definitions with pioglitazone. This shows that we haven't been scrabbling around for one end point that was positive and that whichever MACE end point we used, we would have gotten a similar result.""
• Why Certain Diabetes Drugs Appear To Lower Blood Pressure - Science Daily, 3/4/08 - "Drugs called thiazolidinediones (TDZs), which are used to treat type II diabetes, target and activate PPAR gamma. In addition to controlling blood sugar, these drugs also appear to lower blood pressure ... It appears that when PPAR gamma is activated it initiates a cascade of events that protect the blood vessel ... When we interfere with the PPAR gamma pathway, those protective mechanisms are eliminated and the blood vessel becomes dysfunctional" - I've read all the negative of thiazolidinediones (TDZs) and I still feel the good outweigh the bad.  I take Actos (pioglitazone HCl) to help prevent diabetes among other thing like I feel they will eventually show that it helps prevent advanced glycation end products, a major cause of aging.
• Comparative effects of rosiglitazone and pioglitazone on fasting and postprandial low-density lipoprotein size and subclasses in patients with Type 2 diabetes - Expert Opin Pharmacother. 2008 Feb;9(3):343-9 - "HbA1c, insulin sensitivity (as assessed by the homeostasis model assessment) and LDL size and subclasses did not differ before treatments. Rosiglitazone and pioglitazone resulted in a similar improvement in HbA1c and insulin sensitivity. Fasting total cholesterol increased more after rosiglitazone compared with pioglitazone (p = 0.04), whereas triglycerides decreased after pioglitazone and increased after rosiglitazone ... Pioglitazone was more effective than rosiglitazone in increasing larger LDL concentrations (in both fasting and postprandial status) as well as in reducing levels of atherogenic small, dense particles (in postprandial status only)"
• Clinical trials with thiazolidinediones in subjects with Type 2 diabetes--is pioglitazone any different from rosiglitazone? - Expert Opin Pharmacother. 2008 Feb;9(3):405-20 - "these agents have markedly different effects on lipids. Rosiglitazone increases total, low- and high-density lipoprotein (LDL and HDL) cholesterol, and triglycerides, whereas pioglitazone has no effect on total or LDL cholesterol, increases HDL cholesterol and decreases triglycerides. Both rosiglitazone and pioglitazone decrease inflammatory markers. Furthermore, both rosiglitazone and pioglitazone may cause a small decrease in blood pressure, improve endothelial function and reduce restenosis. Microalbuminuria is also reduced by both rosiglitazone and pioglitazone. Despite the improvements in surrogate end points, there is little clear evidence that either rosiglitazone or pioglitazone cause major improvements in cardiovascular outcomes. Thus, rosiglitazone has no effect or may even increase cardiovascular outcomes, whereas, in high-risk subjects, pioglitazone has a marginal ability to decrease cardiovascular outcomes"
• Why Belly Fat Hurts the Heart - WebMD, 1/29/08 - "Visceral fat brought the most inflammation and the worst atherosclerosis ... After visceral fat transplantation, mice developed less severe atherosclerosis if their chow was laced with the diabetes drug Actos for 10 weeks. But Actos didn't affect atherosclerosis in other mice"
• Thiazolidinediones-improving endothelial function and potential long-term benefits on cardiovascular disease in subjects with type 2 diabetes - J Diabetes Complications. 2008 Jan-Feb;22(1):62-75 - "Insulin-sensitizing agents such as thiazolidinediones have demonstrated a number of clinical benefits, including anti-inflammatory and antithrombotic properties, which may impact on the course of atherosclerosis. Recent studies have demonstrated that thiazolidinediones improve endothelial function in subjects with and without type 2 diabetes"
• Pioglitazone Lowers Cardiovascular Risk in Diabetic Patients with Kidney Disease - Doctor's Guide, 12/12/07
• Diabetes Drug May Up Elderly Deaths - WebMD, 12/11/07 - "Patients taking thiazolidinediones were 29% more likely to die, 40% more likely to have a heart attack, and 60% more likely to develop congestive heart failure than patients taking different types of diabetes drugs"
• Use of Diabetes Medication by Older Adults Linked with Increased Risk of Heart Problems, Death - Doctor's Guide, 12/11/07
• New Diabetes Drugs Bad for Bones - WebMD, 12/3/07 - "The diabetes drug Avandia promotes osteoporosis not only by slowing bone growth but also by speeding up bone loss. Actos, the only other drug in the same class, likely does this as well"
• TZDs May Reduce Lung Cancer Risk - Physician's Weekly, 10/29/07 - "A 33% reduction in lung cancer risk was found among TZD users"
• Rosiglitazone and Pioglitazone Increase Risk of Congestive Heart Failure But Not the Risk of Cardiovascular Death - Doctor's Guide, 10/2/07
• Fresh fuel for the glitazone controversy: New pioglitazone and rosiglitazone meta-analyses - theHeart.org, 9/11/07 - "If one is anticipating that this type of drug would be appropriate, then I think there is now a lot of evidence to suggest that pioglitazone is the preferred drug"
• Pioglitazone Appears to Have Overall Favorable Effect Regarding Risk of Cardiovascular Events - Doctor's Guide, 9/11/07 - "A meta-analysis of previous research suggests that use of pioglitazone, a glycemic control medication for patients with type 2 diabetes, significantly reduces the risk of heart attack, stroke and death, but increases the risk for serious heart failure"
• Diabetes Drugs Increase Risk Of Heart Failure, Research Shows - Science Daily, 7/27/07
• Higher Cancer Prevalence Seen Among Diabetics Taking Thiazolidinediones - Medscape, 7/18/07 - "There was a significant association with rosiglitazone use with an odds ratio of 1.89 (p = 0.02) for malignancy, but not with pioglitazone use (OR = 1.09"
• From Prediabetes to Diabetes to Cardiovascular Complications: Is the Progression Preventable? - Medscape, 5/31/07 - "TZDs have shown considerable promise in preventing or slowing the progression from prediabetes to diabetes and from diabetes to CV complications. Their effects on insulin resistance and myriad intermediates of CVD (eg, lipids, inflammatory cytokines) suggest potential benefits for at-risk patients that may extend beyond improved glucose control"
• The Rosiglitazone Aftermath: Legitimate Concerns or Hype? - Medscape, 5/24/07 - "Haffner added that if the 43% increase in risk shown in the analysis had occurred in the ongoing RECORD study with rosiglitazone, it would have been stopped a year ago. “I think if a proper meta-analysis were done with rosiglitazone, it would probably show some increased risk, but this would not be significant ... the worst-case scenario from these data is that rosiglitazone would elevate risk for MI from 1.4% to 2% ... Nathan believes pioglitazone is a better bet than rosiglitazone, as it does not have the same adverse lipid profile"
• The Effect of Pioglitazone on Recurrent Myocardial Infarction in 2,445 Patients With Type 2 Diabetes and Previous Myocardial Infarction. Results From PROactive (PROactive 05) - Medscape, 4/30/07
• Pioglitazone in Prior MI Patients - Medscape, 4/23/07
• Diabetes drug 'protects arteries' - BBC News, 3/30/07 - "After 72 week, the thickness of the arteries increased by an average of 0.012 millimetres in the glimepiride group ... But among the patients given pioglitazone, average thickness actually fell by 0.001 millimetres ... Pioglitazone patients also recorded lower levels of sugar in their blood, and higher levels of beneficial HDL cholesterol"
• Actos (Pioglitazone) Tablets - Evaluation of Safety Data Showed Increased Incidence of Fractures in Female Patients - Doctor's Guide, 3/9/07 - "Healthcare professionals should consider the risk of fracture when initiating or treating female patients with type 2 diabetes mellitus with pioglitazone-containing products"
• The Role of Metformin and Pioglitazone in Early Combination Treatment - Medscape, 2/6/07 - "Both metformin and pioglitazone have positive effects on cardiovascular risk factors. Pioglitazone may reduce the progression to type 2 diabetes by effects on both pancreatic beta-cell deterioration and insulin resistance"
• Diabetes Drug [Actos® (pioglitazone)] Shows Promise For Preventing Brain Injury From Radiation Therapy - Science Daily, 1/12/07 - "the diabetes drug pioglitazone prevents inflammation. The drug activates a specific type of peroxisome proliferator-activated receptors (PPARs) that control fat and glucose metabolism, and may be involved in inflammation"
• Anti-Inflammatory Effects of Pioglitazone and/or Simvastatin in High Cardiovascular-Risk Patients With Elevated High Sensitivity C-Reactive Protein: The PIOSTAT Study - Medscape, 1/9/07 - "After 12 weeks of treatment, hs-CRP levels were reduced from 3.64 +/-2.42 mg/l to 2.48 +/-1.77 mg/l with pioglitazone monotherapy and from 3.26 +/-2.02 mg/l to 2.81 +/-2.11 mg/l with simvastatin monotherapy (as illustrated in Fig. 1). Combination treatment with pioglitazone and simvastatin resulted in an additive decrease in hs-CRP levels from 3.49 +/-1.97 mg/l to 2.06 +/-1.42 mg/l after 12 weeks"
• Diabetes Drug Actos May Cut Heart Risk - WebMD, 12/5/06 - "Patients taking Actos had less wall thickening of their carotid arteries -- which bring blood through the neck to the brain -- over 18 months"
• Long-term Safety of Pioglitazone vs Glyburide for Type 2 Diabetes - Medscape, 12/1/06 - "Patients with type 2 diabetes mellitus achieve glycemic control safely and effectively with both pioglitazone and glyburide treatment; however, the results of this study suggest that long-term treatment with pioglitazone is superior to glyburide with respect to tolerability. Overall, pioglitazone treatment resulted in sustained glycemic control, fewer patient withdrawals due to lack of efficacy or hypoglycemia, and fewer cardiac events compared with glyburide"
• Diabetes Drug May Treat Fatty Liver - WebMD, 11/30/06 - "during the study, the Actos patients cut their liver fat by 54%; the placebo group had no change in liver fat ... Actos patients also showed a bigger drop in liver inflammation and a greater improvement in insulin response than the placebo group"
• Pioglitazone Treatment Increases Concentrations of Adiponectin in Plasma - Doctor's Guide, 11/16/06 - "Results showed there was a 6.9 mcg/mL mean increase in adiponectin levels in the pioglitazone group while in non-pioglitazone patients it decreased by 0.42 mcg/mL"
• Diabetes drug may cut heart risks - MSNBC, 11/13/06 - "Patients with type 2 diabetes taking the older generic drug, glimepiride, saw their artery thickness rise by .012 millimeters after 72 weeks on the drug, while those on pioglitazone saw their artery wall thickness drop by .001 millimeters ... pioglitazone raised HDL levels, which seem to protect against heart attacks, by about 13 percent in patients after 24 weeks, and sustained that increase over the life of the study"
• Thiazolidinediones, Insulin Resistance And Obesity - Medscape, 11/8/06 - "Several studies indicate, rather than a neutral effect, a significant reduction in visceral adipose tissue with TZD therapy.[72-75] In patients taking metformin, however, there is conflicting evidence, with some studies showing no significant change in visceral fat mass[73] and others showing significant decreases with metformin treatment (Figure 5).[74] Rosiglitazone (but not metformin) is also associated with decreases in hepatic fat, as shown by reductions in the liver:spleen attenuation ratio, and, while both agents reduced plasma FFA, the decrease was only statistically significant in the rosiglitazone group"
• duetact(TM) (pioglitazone HCl and glimepiride) Now Available in U.S. Pharmacies - Doctor's Guide, 11/7/06
• Widely Prescribed Diabetes Drug Falls Short Of Promise, Says New Review - Science Daily, 10/21/06
• Widely Prescribed Diabetes Drug Falls Short of Promise, Says New Review - Doctor's Guide, 10/18/06
• Cochrane: Pioglitazone benefit unclear - Medscape, 10/18/06 - "They found that these studies did not provide convincing evidence that patient-oriented outcomes such as mortality, morbidity, adverse effects, costs, and health-related quality of life are positively influenced by pioglitazone. Metabolic control measured by glycosylated hemoglobin A1c as a surrogate end point did not demonstrate clinically relevant differences from other oral antidiabetic drugs, and the occurrence of edema was significantly raised with pioglitazone ... Metformin should be the first drug of choice"
• 'Diabetes' Treatment Stops Alzheimer's - WebMD, 9/25/06 - "Alzheimer's disease is really "type 3 diabetes" -- that is, a kind of brain diabetes ... The drug de la Monte and colleagues found so useful for rats is very similar to two drugs currently used to treat diabetes: Actos and Avandia. Known as "TZDs" or "glitazones," the drugs make the body's cells more sensitive to insulin"
• Pioglitazone HCl Demonstrates Significant Improvements in Cardiovascular Outcomes for High-Risk Patients with Type 2 Diabetes - Doctor's Guide, 9/14/06 - "Compared to placebo, patients treated with Actos demonstrated statistically significant risk reductions of heart attacks (23%, P =.046), the combined risk of cardiovascular death, nonfatal heart attack or nonfatal stroke (18%, P =.020) and the combined risk of all-cause mortality, nonfatal heart attack, nonfatal stroke or acute coronary syndrome (17%, P =.010)"
• Pioglitazone Reduces Risk of Second Stroke in Diabetic Patients; No Impact Seen on Risk of First Ever Events - Doctor's Guide, 9/5/06
• PROactive: Pioglitazone Reduces Recurrent Stroke in Patients with Diabetes - Medscape, 9/4/06 - "the risk of recurrent stroke was reduced among patients with a history of stroke for those treated with pioglitazone relative to those not treated, from 10% to about 5% in treated patients, a significant reduction ... Biochemical and diabetic changes from baseline showed a greater reduction in HbA1c, systolic and diastolic BP, and triglycerides, even more of an increase in HDL cholesterol and more of a decrease in the LDL/HDL ratio with pioglitazone treatment"
• Diabetes Drug Shows Promise in Treating Alzheimer's - Doctor's Guide, 7/17/06 - "Treatment of high blood sugar may have a scientific connection to memory loss that could, one day, benefit millions of people with Alzheimer's Disease ... The drug, called pioglitazone HCl"
• Diabetes Drug Shows Promise In Treating Alzheimer's - Science Daily, 7/17/06
• Women Gain More Weight Than Men When Taking Thiazolidinedione - Doctor's Guide, 5/3/06 - "Among the 100 consecutive patients treated with thiazolidinediones, 52 gained significant weight. There were more women in the group of weight-gainers compared to the group of non-weight-gainers (63.5% vs. 37.5%, P <.05)"
• Higher Risk Patients Benefit More After Conversion from Pioglitazone to Rosiglitazone - Doctor's Guide, 5/3/06 - "conversion from rosiglitazone to pioglitazone while maintaining statin therapy, improves the lipid profiles in patients with type 2 diabetes"
• Pioglitazone Has Cholesterol Advantages Versus Rosiglitazone in Elderly Diabetics - Doctor's Guide, 5/2/06 - "patients receiving pioglitazone showed improvements from baseline compared with rosiglitazone in TG, HDL-C, as well as LCL-C particle concentration and size ... Although both agents increased HDL-C, the increase achieved with pioglitazone was significantly greater"
• Rosiglitazone and Pioglitazone on Cardiovascular Risk - Medscape, 4/3/06
• Insulin Sensitizers Cut Cognitive Decline in AD - Clinical Psychiatry News, 4/06 - "There is a critical relationship between insulin resistance and key aspects of brain function ... patients taking rosiglitazone performed significantly better than those taking placebo on a delayed memory task (the Buschke Selective Reminding Test)"
• Newer Diabetic Meds Cost More, But Users Have Fewer Hospital Visits - Science Daily, 3/24/06 - "Taking a TZD as instructed was the strongest predictor of a reduced risk of hospitalization and decreased healthcare costs in this group of patients ... Overall, the participants who took a TZD spent an average of $76 to $150 less per month on total healthcare costs"
• Pioglitazone Treatment Reduces Risk of Second Heart Attack in Diabetics - Doctor's Guide, 11/18/05
• ACTOplus met (pioglitazone HCl and metformin HCl) Now Available in U.S. Pharmacies - Doctor's Guide, 11/1/05
• Drug Can Reduce Risk of Death, Heart Attack, and Stroke in Diabetes Patients - Doctor's Guide, 10/7/05
• Actos Effective in Late-Stage Type 2 Diabetes - Doctor's Guide, 10/6/05
• PROactive Study Shows Takeda's Actos (Pioglitazone HCl) Reduces Heart Attacks, Strokes and Deaths - Doctor's Guide, 9/13/05
• ACTOplus Met Approved by the FDA for Type 2 Diabetes - Doctor's Guide, 8/30/05 - "ACTOplus met combines ACTOS (pioglitazone HCl) and metformin, two widely used diabetes medications, in a single tablet"
• Review: Metformin a Top Diabetes Drug - WebMD, 7/19/05 - "Though many of the newer drugs may promote weight gain, metformin has been associated with modest weight losses in people with type 2 diabetes"
• A Comparison of Lipid and Glycemic Effects of Pioglitazone and Rosiglitazone in Patients With Type 2 Diabetes and Dyslipidemia - Medscape, 7/14/05
• Actos (Pioglitazone HCl) Significantly Improved Components of Diabetic Dyslipidemia - Doctor's Guide, 6/29/05 - "triglyceride levels decreased 12.0 percent in the Actos patients, and rose 14.9 percent in the Avandia patients"
• Pioglitazone May Decrease Cardiovascular Risk Factors Independent of Glycemic Control - Medscape, 6/20/05 - "A medication regimen for type 2 diabetes based on pioglitazone is associated with higher HDL cholesterol levels, reduced CRP levels, and improved carotid intima-media thickness, compared with a regimen based on glimepiride. This effect appears independent of glycemic control"
• Diabetes Drugs May Help Fight Inflammation - WebMD, 6/20/05 - "the type 2 diabetes drugs Actos and Avandia may help fight heart disease not only by improving blood sugar but also by battling inflammation ... Carotid artery wall thickness, a measure of arteries that supply the brain and an indicator of heart disease, also improved with Actos"
• Diabetes Drug Actos (pioglitazone HCl) Showed Anti-Inflammatory Effects in Patients with Type 2 Diabetes in a Clinical Study - Doctor's Guide, 6/16/05 - "CRP decreased by 6.98 mg/L compared to 1.55 mg/L for placebo (p= 0.001). IL-6 decreased by 0.78 pg/mL compared to 0.22 pg/ml for placebo"
• Investigative Drug Muraglitazar (Pargluva) Tops Pioglitazone (Actos) for Blood Glucose Lowering and Lipid Control: Presented at ADA - Doctor's Guide, 6/15/05
• Long-Term, First-Line Monotherapy With Pioglitazone Improves Lipid Profiles in Type 2 Diabetics: Presented at ADA - Doctor's Guide, 6/14/05
• Treatment Switch from Rosiglitazone to Pioglitazone Improves Lipid Measures in Type 2 Diabetics with Dyslipidemia: Presented at ADA - Doctor's Guide, 6/14/05
• Pioglitazone Lowers Blood Pressure in Patients With Diabetes - Medscape, 5/20/05 - "mean DBP values were lowered by -3.1mm Hg and SBP values by -6.9mm Hg. In the stage II hypertension group, treatment with pioglitazone lowered mean DBP values by -8.3mm Hg and SBP values by -18.7mm Hg ... an average change of 2mm Hg will alter the incidence of cardiovascular disease by 17% and ischaemic heart disease by 10% ... Improving insulin sensitivity is associated with a decrease in blood pressure" - See pioglitazone at OffshoreRx1.com,
• Diabetes Medication Pioglitazone HCl May Significantly Improve Predictors of Cardiovascular Risk - Doctor's Guide, 5/10/05 - "the diabetes medication pioglitazone HCl reduced carotid artery intima-media thickness (IMT). Patients taking pioglitazone also experienced significant reductions in insulin resistance, C-reactive protein (a marker for inflammation) and blood pressure, all of which contribute to the overall risk for cardiovascular disease"
• Pioglitazone and Metformin Similarly Effective in Reducing HbA1c - Medscape, 12/13/04
• Pioglitazone Associated With Substantial Regression in Carotid Intima-Media Thickness in Diabetic Patients - Doctor's Guide, 11/10/04
• Pioglitazone Plus Sulfonylurea/Metformin Therapy for Type 2 Diabetes Improves Glucose Control with Fewer Hypoglycaemic Episodes than Insulin - Doctor's Guide, 3/1/04
• Repaglinide Plus Pioglitazone Improves Blood Glucose Control in Type 2 Diabetes Better Than Either Agent Alone - Doctor's Guide, 2/23/04
• Repaglinide/Pioglitazone Combination Therapy Appears Safe, Effective for Patients with Type 2 Diabetes - Doctor's Guide, 2/3/04
• Caution Urged With Diabetes Drugs - WebMD, 12/8/03
• Pioglitazone May Help Children With Type 2 Diabetes Mellitus - Doctor's Guide, 10/6/03
• Pioglitazone Improves Cardiovascular Risk Profile of Patients with Type 2 Diabetes - Doctor's Guide, 10/2/03
• Pioglitazone Exerts Antiatherogenic Effect Independent of Antidiabetic Effect - Doctor's Guide, 9/15/03
• Pioglitazone Decreases Dense LDL in Non-Diabetic Hypertensives - Doctor's Guide, 9/15/03
• Caution Urged on Popular Diabetes Drugs - HealthDay, 9/9/03
• Pioglitazone And Rosiglitazone May Cause Heart Failure And Fluid Build-Up - Doctor's Guide, 9/9/03
• Studies Reveal Good News Regarding Liver Safety of Pioglitazone - Doctor's Guide, 5/21/03
• Pioglitazone/Sulfonylurea And Pioglitazone/Metaformin Combinations Both Effective For Reducing Very Low Density Lipoproteins And Free Fatty Acids - Doctor's Guide, 5/21/03
• Pioglitazone Helpful in Diabetes Therapy - Medscape, 5/19/03
• Pioglitazone Improves Insulin Sensitivity Compared To Metformin - Doctor's Guide, 4/22/03
• Rosiglitazone, Pioglitazone Safe for Type 2 Diabetes , But Effect on Lipid Levels Should Be Considered - Doctor's Guide, 12/6/02
• New Study Indicates Pioglitazone HCl/Metformin Combination Therapy Enhances Glycemic Control in Patients With Type 2 Diabetes - Doctor's Guide, 11/7/02 - "Diabetes patients taking the insulin sensitizer pioglitazone HCl in combination with metformin experienced significantly greater improvement in triglyceride levels than patients taking rosiglitazone maleate and metformin"
• Pioglitazone Improves Lipid Profile in Hypertensive Patients - Doctor's Guide, 9/5/02
• Pioglitazone Has Better Effect on Lipid Profiles than Rosiglitazone - Doctor's Guide, 6/17/02
• Actos (Pioglitazone HCl) Improves Glucose Control And Lipid Profiles In People With Type 2 Diabetes Who Use Insulin - Doctor's Guide, 5/31/02
• Long-term Lipid Benefits of Pioglitazone Appear For Type 2 Diabetics - Doctor's Guide, 5/3/02
• Pioglitazone Controls Glycaemia And Blood Pressure, Increases Body Mass Index - Doctor's Guide, 4/8/02
• Actos (Pioglitazone) Shows Greater Improvement In Lipid Profiles Compared To Rosiglitazone - Doctor's Guide, 3/21/02
• Weight Gain In Diabetics On Pioglitazone Related To Shorter Disease Duration, Increased Adiposity - Doctor's Guide, 6/25/01
• Pioglitazone Effectively Reduces Blood Glucose Levels In Type 2 Diabetes - Doctor's Guide, 3/9/01
• Actos (Pioglitazone HCl) Improves Glucose Control in Type 2 Diabetics - Doctor's Guide, 12/5/00
• Pioglitazone May Improve Glycaemic Control In Combination With Sulphonylurea Therapy - Doctor's Guide, 9/19/00
• Actos (Pioglitazone) Improves Lipid Profiles In Patients With Type 2 Diabetes - Doctor's Guide, 6/29/00
• Pioglitazone Corrects Lipid Imbalance While Lowering Plasma Glucose - Doctor's Guide, 9/29/99
• Pioglitazone Causes Few, If Any, Drug Interactions - Doctor's Guide, 9/29/99
• Actos Approved By FDA For Type II Diabetes - Doctor's Guide, 7/16/99

Pioglitazone Abstracts:

• Pioglitazone effects on blood pressure in patients with metabolic syndrome - Nippon Rinsho. 2008 Aug;66(8):1591-5 - "Although blood pressure lowering effect of pioglitazone is small, several clinical trials and a meta-analysis indicated that it decreases both systolic and diastolic blood pressure. Pioglitazone has favorable effects on important components of metabolic syndrome including blood pressure"
• Acarbose Treatment Increases Serum Total Adiponectin Levels in Patients with Type 2 Diabetes - Endocr J. 2008 May 15 - "Treatment with acarbose and pioglitazone decreased HbA1c values by 0.49 % and 0.63 %, respectively. Pioglitazone, as expected, increased serum levels of total adiponectin by 2.1 fold and its high molecular weight isoform by 3.6 fold. We found that acarbose also caused a small but significant increase in serum concentrations of total adiponectin. However, in contrast to pioglitazone, no appreciable changes were observed in the levels of high molecular weight adiponectin"
• Peroxisome Proliferator-Activated Receptor gamma agonism modifies the effects of growth hormone on lipolysis and insulin sensitivity - Clin Endocrinol (Oxf). 2008 Mar 10 - "Peroxisome Proliferator-Activated Receptor gamma (PPARgamma) agonists such as thiazolidinediones (TZD) improve insulin sensitivity in type 2 diabetes via effects on fat metabolism, whereas growth hormone (GH) stimulates lipolysis and induces insulin resistance ...Randomized, placebo-controlled, double-blind parallel-group study including 20 GH-deficient patients on continued GH replacement therapy. The patients were studied before and after 12 weeks ... Adiponectin levels almost doubled during pioglitazone treatment (P = 0.0001). Pioglitazone significantly decreased basal free fatty acid levels (P = 0.02) and lipid oxidation (P = 0.02). Basal glucose oxidation rate (P = 0.004) and insulin sensitivity (P = 0.03) improved in the patients who received pioglitazone treatment. The change in insulin-stimulated adiponectin level after pioglitazone treatment was positively correlated to the change in insulin-stimulated total glucose disposal (R = 0.69 ... The impact of GH on lipolysis and insulin sensitivity is modifiable by administration administration of TZD"
• The PPARgamma agonist pioglitazone is effective in the MPTP mouse model of Parkinson's disease through inhibition of monoamine oxidase B - Br J Pharmacol. 2008 Mar 10 - "The peroxisome proliferator-activated receptor-gamma (PPARgamma) agonist pioglitazone has previously been shown to attenuate dopaminergic cell loss in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) mouse model of Parkinson's disease, an effect attributed to its anti-inflammatory properties. In the present investigation, we provide evidence that pioglitazone is effective in the MPTP mouse model, not via an anti-inflammatory action, but through inhibition of MAO-B, the enzyme required to biotransform MPTP to its active neurotoxic metabolite 1-methyl-4-phenylpyridinium (MPP+) ... Mice treated with MPTP showed deficits in motor performance, marked depletions in striatal dopamine levels and a concomitant reduction in TH immunoreactivity in the substantia nigra. Pretreatment with pioglitazone completely prevented these effects of MPTP. However, pretreatment with pioglitazone also significantly inhibited the MPTP-induced production of striatal MPP+ and the activity of MAO-B in the striatum"
• Pioglitazone improves myocardial blood flow and glucose utilization in nondiabetic patients with combined hyperlipidemia a randomized, double-blind, placebo-controlled study - J Am Coll Cardiol. 2007 Nov 20;50(21):2051-8 - "myocardial glucose utilization (MGU) and blood flow (MBF) in nondiabetic patients with familial combined hyperlipidemia (FCHL) ... in the pioglitazone group HDL cholesterol (+28%; p = 0.003) and adiponectin (+156.2%; p = 0.0001) were increased and plasma insulin (-35%; p = 0.017) was reduced ... In patients with FCHL treated with conventional lipid-lowering therapy, the addition of pioglitazone led to significant improvements in MGU and MBF, with a favorable effect on blood lipid and metabolic parameters"
• Thiazolidinediones: A novel class of drugs for the prevention of diabetic nephropathy? - Kidney Int. 2007 Dec;72(11):1301-1303 - "Miyazaki et al. report that rosiglitazone, a thiazolidinedione insulin sensitizer and a potent peroxisome proliferator-activated receptor gamma agonist, not only effectively improves glycemic control but also halts progression of albuminuria in type 2 diabetic patients with early-stage diabetic nephropathy. These findings could offer a new prevention of diabetic nephropathy in insulin-resistant diabetic patients"
• Renoprotection provided by losartan in combination with pioglitazone is superior to renoprotection provided by losartan alone in patients with type 2 diabetic nephropathy - Kidney Blood Press Res. 2007;30(4):203-11 - "Renoprotection conferred by losartan combined with pioglitazone is superior to that conferred by losartan alone in subjects with type 2 diabetic nephropathy. The combination is generally well tolerated"
• Congestive heart failure and cardiovascular death in patients with prediabetes and type 2 diabetes given thiazolidinediones: a meta-analysis of randomised clinical trials - Lancet. 2007 Sep 29;370(9593):1129-36 - "Compared with controls, patients given TZDs had increased risk for development of congestive heart failure across a wide background of cardiac risk (relative risk [RR] 1.72, 95% CI 1.21-2.42, p=0.002). By contrast, the risk of cardiovascular death was not increased with either of the two TZDs (0.93, 0.67-1.29, p=0.68) ... Congestive heart failure in patients given TZDs might not carry the risk that is usually associated with congestive heart failure which is caused by progressive systolic or diastolic dysfunction of the left ventricle"
• Pioglitazone Exerts Protective Effects Against Stroke in Stroke-Prone Spontaneously Hypertensive Rats, Independently of Blood Pressure - Stroke. 2007 Sep 20 - "Our work provides the first evidence that pioglitazone significantly protects against hypertension-induced cerebrovascular injury and stroke by improving vascular endothelial dysfunction, inhibiting brain inflammation, and reducing oxidative stress. These beneficial effects of pioglitazone were independent of blood pressure or blood sugar values. Thus, pioglitazone appears to be a potential therapeutic agent for stroke in type 2 diabetes with hypertension"
• Rationale for the use of insulin sensitizers to prevent cardiovascular events in type 2 diabetes mellitus - Am J Med. 2007 Sep;120(9 Suppl 2):S18-25 - "TZDs, acting via the peroxisome proliferator-activated receptor-gamma, affect a number of mediators involved in the development of the cardiovascular complications of diabetes, including lipid profiles, vascular changes, and inflammatory mediators. TZDs decrease plasminogen activator-1 and C-reactive protein levels. They also reduce the extent of thickening of the carotid artery and reduce hyperplasia after coronary stent implantation. Insulin-sensitizing therapy with TZDs is a promising intervention for patients with diabetes at risk for adverse cardiovascular outcomes"
• Pioglitazone and Risk of Cardiovascular Events in Patients With Type 2 Diabetes Mellitus: A Meta-analysis of Randomized Trials - JAMA. 2007 Sep 12;298(10):1180-1188 - "Pioglitazone is associated with a significantly lower risk of death, myocardial infarction, or stroke among a diverse population of patients with diabetes. Serious heart failure is increased by pioglitazone, although without an associated increase in mortality"
• The cardiovascular effects of the thiazolidinediones: a review of the clinical data - J Diabetes Complications. 2007 Sep-Oct;21(5):326-34 - "Beyond glycemic control, the thiazolidinediones (TZDs) provide numerous cardiovascular benefits. Clinical data support a role for the TZDs in lowering blood pressure, correcting dyslipidemia, improving vascular structure and function, decreasing inflammation, improving the adipokine profile, reducing systemic oxidative stress, and possibly in stabilizing coronary plaques that may be prone to rupture ... Reported side effects of the TZDs include fluid retention, worsening of heart failure, and weight gain"
• Effects of early use of pioglitazone in combination with metformin in patients with newly diagnosed type 2 diabetes - Curr Med Res Opin. 2007 Aug;23(8):1775-81 - "early use of combination therapy at time of diagnosis or within the first 3-6 months following diagnosis with metformin plus pioglitazone in newly diagnosed type 2 diabetes results in a slower deterioration in glycaemic control than that with metformin combined with either gliclazide or repaglinide. This may be due to the beta-cell protective properties of pioglitazone"
• Effects of pioglitazone on lipid and lipoprotein metabolism - Diabetes Obes Metab. 2007 Sep;9(5):640-7 - "In the monotherapy setting, pioglitazone has been associated with greater decreases in TGs and increases in HDL-C when compared with glibenclamide or metformin. Studies investigating the effects of pioglitazone add-on therapy to either metformin or sulphonylurea treatments have shown sustained improvements in serum levels of TGs and HDL-C and favourable effects on LDL-C particle size. In comparison with rosiglitazone, pioglitazone has different and potentially favourable effects on plasma lipids. The recent PROspective pioglitAzone Clinical Trial In macroVascular Events study has given weight to the hypothesis that the beneficial metabolic effects of pioglitazone may be associated with reductions in cardiovascular risk in patients with type 2 diabetes" - Note:  When I switched from pioglitazone to rosiglitazone, my HDL when from 57 to 47.  I'm switching back when I run out of rosiglitazone.  I've been taking them to prevent diabetes.
• Effects of pioglitazone on lipid and lipoprotein metabolism - Diabetes Obes Metab. 2007 Sep;9(5):640-7 - "In the monotherapy setting, pioglitazone has been associated with greater decreases in TGs and increases in HDL-C when compared with glibenclamide or metformin. Studies investigating the effects of pioglitazone add-on therapy to either metformin or sulphonylurea treatments have shown sustained improvements in serum levels of TGs and HDL-C and favourable effects on LDL-C particle size. In comparison with rosiglitazone, pioglitazone has different and potentially favourable effects on plasma lipids. The recent PROspective pioglitAzone Clinical Trial In macroVascular Events study has given weight to the hypothesis that the beneficial metabolic effects of pioglitazone may be associated with reductions in cardiovascular risk in patients with type 2 diabetes"
• Effects of thiazolidinediones on blood pressure - Curr Hypertens Rep. 2007 Aug;9(4):332-7 - "The magnitude of reduction appears to be about 4 to 5 mm Hg in systolic and 2 to 4 mm Hg in diastolic BP-sufficient to significantly reduce subsequent cardiovascular event rates"
• Pioglitazone Use and Heart Failure in Patients with Type 2 Diabetes and Preexisting Cardiovascular Disease: Data from the PROactive Study (PROactive 08) - Diabetes Care. 2007 Jul 31 - "serious HF (SHF) ... More pioglitazone (5.7%) than placebo patients (4.1%) had a SHF event during the study (P=0.007). However, mortality due to HF was similar (25/2605 [0.96%] for pioglitazone versus 22/2633 [0.84%] for placebo; P=0.639). Among patients with a SHF event, subsequent all-cause mortality was proportionately lower with pioglitazone (40/149 [26.8%]) versus 37/108 [34.3%] with placebo; P=0.1338). Proportionately fewer pioglitazone patients with SHF went on to have an event in the primary (47.7% with pioglitazone versus 57.4% with placebo; P=0.0593) or main secondary endpoint (34.9% with pioglitazone versus 47.2% with placebo; P=0.025)"
• Pioglitazone Decreases Ambulatory Blood Pressure in Type 2 Diabetics With Difficult-to-Control Hypertension - J Clin Hypertens (Greenwich). 2007 Jul;9(7):530-7 - "add-on therapy with pioglitazone 30 to 45 mg for 20 weeks. After 20 weeks of treatment, 24-hour ambulatory BP monitoring showed significant reductions (from 144+/-13 to 136+/-16 mm Hg systolic BP and from 79+/-9 to 76+/-10 mm Hg diastolic BP [P=.001]). Treatment was also associated with improvements in insulin sensitivity and glycemic and lipid profile"
• The impact of thiazolidinedione use on outcomes in ambulatory patients with diabetes mellitus and heart failure - J Am Coll Cardiol. 2007 Jul 3;50(1):32-6 - "In ambulatory patients with established HF and diabetes, the use of TZDs was not associated with an increased risk of HF hospitalization or total mortality when compared with those not receiving insulin-sensitizing medications"
• Pioglitazone and Rosiglitazone Have Different Effects on Serum Lipoprotein Particle Concentrations and Sizes in Patients with Type 2 Diabetes and Dyslipidemia - Diabetes Care. 2007 Jun 26 - "PIO-treatment increased total VLDL particle concentration less than ROSI-treatment and decreased VLDL particle size more than ROSI. PIO-treatment reduced total LDL particle concentration whereas ROSI-treatment increased it. Both treatments increased LDL particle size, with PIO-treatment having a greater effect. Whereas PIO-treatment increased total HDL particle concentration and size, ROSI-treatment decreased them; both increased HDL cholesterol levels"
• Pioglitazone has anti-inflammatory effects in patients with Type 2 diabetes - J Endocrinol Invest. 2007 Apr;30(4):292-7 - "Pioglitazone treatment results in reduced A1GP concentration suggesting an anti-inflammatory effect"
• The effect of pioglitazone on recurrent myocardial infarction in 2,445 patients with type 2 diabetes and previous myocardial infarction: results from the PROactive (PROactive 05) Study - J Am Coll Cardiol. 2007 May 1;49(17):1772-80 - "In high-risk patients with type 2 diabetes and previous MI, pioglitazone significantly reduced the occurrence of fatal and nonfatal MI and ACS"
• Treating the metabolic syndrome - Expert Rev Cardiovasc Ther. 2007 May;5(3):491-506 - "appropriate treatment of MS components often requires pharmacologic intervention with insulin-sensitizing agents, such as metformin and thiazolidinediones, while statins and fibrates, or angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers are the first-line lipid-modifying or antihypertensive drugs"
• Pioglitazone added to conventional lipid-lowering treatment in familial combined hyperlipidaemia improves parameters of metabolic control: Relation to liver, muscle and regional body fat content - Atherosclerosis. 2007 May 4 - "Significantly improved in the pioglitazone group were: triglyceride/HDL (atherogenic index of plasma) -32.3% (p=0.002), plasma glucose -4.4% (p=0.03), alanine-aminotransferase (ALT) -7.7% (p=0.005) and adiponectin 130.1% (p=0.001). Pioglitazone treatment resulted in a significant increase in total (5.3%, p=0.02) and subcutaneous (7.1%, p=0.003) adipose tissue as well as in soleus-IMCL levels (47.4%, p=0.02) without alteration in intra-abdominal AT or IHCL. Changes in ALT and AST and IHCL were strongly correlated (r=0.72, p<0.01; r=.0.86, p<0.01, respectively). In patients with FCHL on conventional lipid-lowering therapy, the addition of pioglitazone acts favourably on several metabolic parameters"
• Thiazolidinediones and the risk of lung, prostate, and colon cancer in patients with diabetes - J Clin Oncol. 2007 Apr 20;25(12):1476-81 - "We observed a 33% reduction in lung cancer risk among TZD users compared with nonusers after adjusting for confounder interactions ... The risk reduction for colorectal and prostate cancers did not reach statistical significance"
• Thiazolidinediones and vascular damage - Current Opinion in Endocrinology, Diabetes & Obesity. 14(2):108-115, April 2007 - "The thiazolidinedione class improves endothelial vasomotion, inhibits inflammatory and procoagulant processes and has powerful antiproliferative and antioxidant effects. Experimentally these agents retard atherosclerosis development in predisposed animals. Clinical studies demonstrate that they increase HDL cholesterol and LDL size, and may lower triglyceride levels. They modestly lower blood pressure, reduce microalbuminuria, arterial stiffness and reduce carotid wall thickening. These effects are generally independent of glucose lowering and in many instances have been shown to occur in nondiabetic subjects"
• Effects of Pioglitazone in Patients With Type 2 Diabetes With or Without Previous Stroke. Results From PROactive (PROspective pioglitAzone Clinical Trial In macroVascular Events 04) - Stroke. 2007 Feb 8 - "In a subgroup analysis from PROactive, pioglitazone reduced the risk of recurrent stroke significantly in high-risk patients with type 2 diabetes"
• Effect of pioglitazone on atherogenic outcomes in type 2 diabetic patients: A comparison of responders and non-responders - Diabetes Res Clin Pract. 2007 Feb 1 - "These results strongly suggest that pioglitazone is beneficial for type 2 diabetic patients with high levels of BMI, HOMA-IR, LDL-C, and RLP-C, as it helps to prevent the progression of atherosclerosis, including coronary heart diseases"
• Metabolic effects of pioglitazone and rosiglitazone in patients with diabetes and metabolic syndrome treated with metformin - Intern Med J. 2007 Feb;37(2):79-86 - "Significant total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, apolipoprotein A-I, and apolipoprotein B improvement was observed in pioglitazone group after 12 months, but not in the rosiglitazone group"
• Comparison of the effects of pioglitazone and metformin on insulin resistance and hormonal markers in patients with impaired glucose tolerance and early diabetes - Hypertens Res. 2007 Jan;30(1):23-30 - "pioglitazone was superior to metformin for the improvement of insulin resistance and adiponectin ... Early intervention with pioglitazone or metformin therapy may reduce the incidence of future cardiovascular disease in subjects with impaired glucose tolerance or early diabetes"
• Fenofibrate and pioglitazone improve endothelial function and reduce arterial stiffness in obese glucose tolerant men - Atherosclerosis. 2006 Dec 2 - "Pioglitazone and fenofibrate treatment of obese, glucose tolerant men reduces inflammation, improves markers of endothelial function and reduces arterial stiffness. These results suggest that treatment with PPAR agonists has potential to reduce the incidence of premature cardiovascular disease associated with obesity"
• Effects of rosiglitazone and pioglitazone combined with metformin on the prothrombotic state of patients with type 2 diabetes mellitus and metabolic syndrome - J Int Med Res. 2006 Sep-Oct;34(5):545-55 - "In patients with type 2 diabetes mellitus and metabolic syndrome, the combination of metformin plus thiazolidinediones improved glycaemic control and produced a slight but significant reduction in plasminogen activator inhibitor-1 levels"
• Effect of Pioglitazone Compared With Glimepiride on Carotid Intima-Media Thickness in Type 2 Diabetes: A Randomized Trial - JAMA, 12/6/06 - "Carotid artery intima-media thickness (CIMT) is a marker of coronary atherosclerosis and independently predicts cardiovascular events ... Over an 18-month treatment period in patients with type 2 DM, pioglitazone slowed progression of CIMT compared with glimepiride"
• Assessment of left ventricular diastolic function with pioglitazone in type 2 diabetic patients - J Cardiol. 2006 Nov;48(5):263-7 - "Pioglitazone administration improves and cessation worsens left ventricular diastolic function"
• A placebo-controlled trial of pioglitazone in subjects with nonalcoholic steatohepatitis - N Engl J Med. 2006 Nov 30;355(22):2297-307 - "Diet plus pioglitazone, as compared with diet plus placebo, improved glycemic control and glucose tolerance (P<0.001), normalized liver aminotransferase levels as it decreased plasma aspartate aminotransferase levels (by 40% vs. 21%, P=0.04), decreased alanine aminotransferase levels (by 58% vs. 34%, P<0.001), decreased hepatic fat content (by 54% vs. 0%, P<0.001), and increased hepatic insulin sensitivity (by 48% vs. 14%"
• Metformin and pioglitazone: Effectively treating insulin resistance - Curr Med Res Opin. 2006;22 Suppl 2:S27-37 - "The different insulin-sensitizing mechanisms of metformin and the thiazolidinediones are manifest in partially distinct effects on hepatic and peripheral glucose homeostasis, and clinical studies show improved glucose control with combination therapy. Both metformin and thiazolidinediones may also have pancreatic beta-cell preserving properties. Furthermore, they have different beneficial effects on several other metabolic risk markers and risk factors for cardiovascular disease. Whereas the thiazolidinediones (particularly pioglitazone) have greater effects on multiple aspects of dyslipidemia, metformin has anorexigenic properties. They also have distinct effects on levels of mediators involved in inflammation and endothelial dysfunction, and outcome studies suggest that either pioglitazone or metformin may reduce the risk of macrovascular events"
• A fixed-dose combination of pioglitazone and metformin: A promising alternative in metabolic control - Curr Med Res Opin. 2006;22 Suppl 2:S39-48 - "Pioglitazone increases insulin sensitivity, while metformin reduces hepatic gluconeogenesis and improves peripheral glucose uptake. Both agents reduce hyperglycemia and hyperinsulinemia, and appear to protect beta-cell function ... In randomized studies, pioglitazone and metformin administered separately provided significantly better glycemic control than metformin monotherapy or metformin plus gliclazide. Pioglitazone and metformin have complimentary benefits on diabetic dyslipidemia; pioglitazone primarily improves high-density lipoprotein cholesterol and triglyceride levels (to a greater extent than rosiglitazone does), while metformin mainly improves total cholesterol. Pioglitazone and metformin also modulate other atherosclerosis biomarkers, including inflammatory mediators, coagulation thrombosis components, and carotid intima media thickness. Together, these pleiotropic effects have the potential to confer a reduced risk of cardiovascular disease in patients with type 2 diabetes. Pioglitazone and metformin are well tolerated in combination, with low rates of hypoglycemia, and the convenience of a single tablet may be expected to aid dosing compliance"
• Hepatic safety profile and glycemic control of pioglitazone in more than 20,000 patients with type 2 diabetes mellitus: Postmarketing surveillance study in Japan - Diabetes Res Clin Pract. 2006 Nov 14 - "No case of hepatic failure was reported, and neither temporal nor dose relations were found between pioglitazone and ALT abnormalities"
• Long-term Safety of Pioglitazone versus Glyburide in Patients with Recently Diagnosed Type 2 Diabetes Mellitus - Pharmacotherapy. 2006 Oct;26(10):1388-95 - "With long-term treatment, both glyburide and pioglitazone resulted in comparable glycemic control; however, pioglitazone was associated with less hypoglycemia and fewer withdrawals due to lack of efficacy or adverse events"
• Pioglitazone: an antidiabetic drug with cardiovascular therapeutic effects - Expert Rev Cardiovasc Ther. 2006 Jul;4(4):445-59 - "the use of pioglitazone in addition to an existing optimized macrovascular risk management resulted in a significant reduction of macrovascular endpoints within a short observation period that was comparable to the effect of statins and angiotensin converting enzyme inhibitors in other trials"
• Metformin-pioglitazone and metformin-rosiglitazone effects on non-conventional cardiovascular risk factors plasma level in type 2 diabetic patients with metabolic syndrome - J Clin Pharm Ther. 2006 Aug;31(4):375-83 - "Significant TC, LDL-C, HDL-C, TG improvement was present in the pioglitazone group at 12 months compared with the baseline values, and these variations were significantly different between groups. No TC, LDL-C, TG improvement was present in the rosiglitazone group after 12 months. Significant Lp(a) and HCT improvement was present in the pioglitazone group at 12 months compared with the baseline values, and Lp(a) change was significant compared with the rosiglitazone group. Significant HCT decrease was observed in the rosiglitazone group at the end of the study"
• Effects of pioglitazone versus glipizide on body fat distribution, body water content, and hemodynamics in type 2 diabetes - Diabetes Care. 2006 Mar;29(3):510-4 - "pioglitazone increases total body water, thereby accounting for the majority of weight gain, tended to decrease visceral and abdominal fat content and blood pressure, and reduces systemic vascular resistance"
• TNF-{alpha} induces endothelial dysfunction in diabetic adults, an effect reversible by the PPAR-{gamma} agonist pioglitazone - Eur Heart J. 2006 Jun 8 - "Pioglitazone treatment can convey direct protection against cytokine (TNF-alpha)-induced endothelial dysfunction in humans with an increased cardiovascular risk due to type 2 diabetes"
• Effect of pioglitazone on insulin sensitivity, vascular function and cardiovascular inflammatory markers in insulin-resistant non-diabetic Asian Indians - Diabet Med. 2006 May;23(5):537-43 - "These agents may have a role in decreasing the risk of diabetes and cardiovascular disease in this high-risk population"
• Effects of pioglitazone on endothelial function, insulin sensitivity, and glucose control in subjects with coronary artery disease and new-onset type 2 diabetes - Diabetes Care. 2006 May;29(5):1039-45 - "After 12 weeks, endothelial dysfunction was significantly better in the pioglitazone group ... Pioglitazone improves endothelial dysfunction independently from the observed benefits on insulin sensitivity and beta-cell function in patients with newly diagnosed type 2 diabetes and CAD"
• Insulin resistance - a common link between type 2 diabetes and cardiovascular disease - Diabetes Obes Metab. 2006 May;8(3):237-249 - "In addition to lifestyle changes, PPARgamma agonists such as thiazolidinediones are frequently beneficial and have been shown to ameliorate insulin resistance, while activation of PPARalpha (e.g. by fibrates) can lead to improvements in free fatty acid oxidation and lipid profile, and a reduction in cardiovascular events. The development of agents with both PPARalpha and PPARgamma activity promises added benefits with amelioration of insulin resistance, delayed progression to and of type 2 diabetes and a reduction of CVD"
• Do thiazolidinediones cause heart failure? A critical review - Cleve Clin J Med. 2006 Apr;73(4):390-7 - "TZDs, ie, rosiglitazone and pioglitazone ... Although fluid retention is a worrisome side effect of TZDs, current evidence does not link fluid retention caused by TZDs with worsening heart function"
• Thiazolidinedione (TZD) Use and Bone Loss in Older Diabetic Adults - J Clin Endocrinol Metab. 2006 Apr 11 - "each year of TZD use was associated with greater bone loss at the whole body (additional loss of -0.61% per year; 95% CI: -1.02, -0.21% per year), lumbar spine (-1.23% per year; 95% CI: -2.06, -0.40% per year), and trochanter (-0.65% per year; 95% CI: -1.18, -0.12% per year) in women, but not men, with diabetes"
• Thiazolidinedione effects on blood pressure in diabetic patients with metabolic syndrome treated with glimepiride - Hypertens Res. 2005 Nov;28(11):917-24 - "the association of a thiazolinedione to the glimepiride treatment of type 2 diabetic subjects with metabolic syndrome is associated to a significant improvement in the long-term blood pressure control, related to a reduction in insulin-resistance"
• Proactive study: secondary cardiovascular prevention with pioglitazione in type 2 diabetic patients - Rev Med Liege. 2005 Nov;60(11):896-901
• Cardiovascular effects of the thiazolidinediones - Diabetes Metab Res Rev. 2005 Sep 26 - "thiazolidinediones have beneficial effects on the cardiovascular system independent of their antidiabetic effect. Studies in animals have clearly shown that thiazolidinediones decrease blood pressure, left ventricular hypertrophy, development of atherosclerotic lesions, and protect myocardium from ischemia/reperfusion injury"