Are anti-diabetic agents (rosiglitazone, glyburide, and metformin) associated with weight loss, better glycemic control and a reduction in C-reactive protein?
From: Diabetes Care
- Kahn, S.E., Haffner, S.M., Viberti, G., Herman, W.H., Lachin, J.M., Kravitz, B.G., Yu, D., Paul, G., Holman, R.R., Zinman, B., 2010. Rosiglitazone Decreases C-Reactive Protein to a Greater Extent Relative to Glyburide and Metformin Over 4 Years Despite Greater Weight Gain Observations from A Diabetes Outcome Progression Trial (ADOPT). Dia Care 33, 177–183.
- 904 subjects over 4 years
- Eligible subjects were aged 30 –75 years and had a fasting plasma glucose concentration between 7 and 10 mmol/l despite diet and exercise intervention.
- Eligible subjects were randomly assigned to one of the three glucose-lowering medications.
- Initial daily doses were 4 mg of rosiglitazone, 500 mg of metformin, or 2.5 mg of glyburide, and the dose was adjusted to the maximum effective daily dose (4 mg of rosiglitazone twice daily, 1 g of metformin twice daily, and 7.5 mg of glyburide twice daily).
- C-Reactive Protein (CRP) reduction was greater in the rosiglitazone group by 47.6% relative to glyburide and by 30.5% relative to metformin at 48 months.
- At month 12, patients treated with rosiglitazone or glyburide gained an average of 3.6 and 2.8 kg, respectively, whereas patients treated with metformin lost 2.2 kg. At month 48, patients treated with rosiglitazone had significantly greater weight gain compared with those treated with glyburide and metformin.
- The change in CRP from commencement to 12 months was correlated positively with change in BMI in glyburide and metformin groups but not in the rosiglitazone group.
- Rosiglitazone treatment was associated with durable reductions in CRP.
- CRP in the glyburide and metformin groups was positively associated with changes in weight, but this was not the case with rosiglitazone.
- Yes (with confidence) – rosiglitazone group in terms of CRP reduction.
- Yes (with confidence) - glyburide and metformin groups in terms of weight loss.
- CRP (C-reactive protein) is closely associated with obesity and cardiovascular disease