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Predictive clinical parameters for therapeutic efficacy of rosiglitazone in Korean type 2 diabetes mellitus

Authors
 Yoo Mee Kim  ;  Bong Soo Cha  ;  Dae Jung Kim  ;  Sung Hee Choi  ;  Soo Kyung Kim  ;  Chul Woo Ahn  ;  Sung-Kil Lim  ;  Kyung Rae Kim  ;  Kap Bum Huh  ;  Hyun Chul Lee 
Citation
 DIABETES RESEARCH AND CLINICAL PRACTICE, Vol.67(1) : 43-52, 2005 
Journal Title
 DIABETES RESEARCH AND CLINICAL PRACTICE 
ISSN
 0168-8227 
Issue Date
2005
MeSH
Adult ; Blood Glucose/metabolism ; Blood Pressure ; C-Peptide/blood ; Diabetes Mellitus, Type 2/drug therapy* ; Female ; Glycated Hemoglobin A/analysis ; Humans ; Hypoglycemic Agents/therapeutic use* ; Korea ; Male ; Middle Aged ; Patient Selection ; Rosiglitazone ; Thiazolidinediones/therapeutic use*
Keywords
Rosiglitazone ; Thiazolidinedione ; Insulin resistance ; Type 2 diabetes mellitus ; Ethnicity
Abstract
This study evaluated the efficacy of rosiglitazone in non-obese and obese Korean type 2 diabetic patients of long duration. A total of 125 patients (M:F = 44:81, mean age: 58.4 ± 9.1 years, BMI: 24.2 ± 2.7 kg/m2, duration of diabetes: 11.0 ± 6.4 years) were randomly allocated to 12 weeks of rosiglitazone treatment (4 mg per day) or a control group. Responders were defined as patients who experienced fasting plasma glucose (FPG) reduction of >20% or HbA1c reduction of >1 (%). Rosiglitazone significantly improved glycemic control by reducing FPG and HbA1c (−3.4 mmol/l and −1.1%, P < 0.001, respectively). It also significantly increased HOMAβ-cell function (+9.7, P < 0.01) and QUICKI (+0.029, P < 0.001), and decreased HOMAIR (−1.73, P < 0.001). Females and those with higher waist–hip ratio made up a greater portion of rosiglitazone-responders. Responders (45 patients, 75%) also showed significantly higher FPG, HbA1c, systolic blood pressures, fasting insulin levels and HOMAIR, and lower QUICKI than nonresponders. Among these parameters of responders, waist–hip ratio of non-obese subgroup, initial glycemic control of obese subgroup, and systolic blood pressure of both subgroups lost their significance after subdivision analysis. However, the baseline HOMAIR and QUICKI were significantly correlated with the response rate to rosiglitazone. Moreover, in multiple logistic regression analysis, HOMAIR and QUICKI retained their significance as the independent predictors. Even in Korean type 2 diabetic patients of long duration but with relatively preserved β-cell function, rosiglitazone improved glycemic control, insulin sensitivity, and β-cell function. In this ethnic group, female gender, central obesity, and especially severe insulin resistance were identified as predictive clinical parameters of rosiglitazone-responders.
Full Text
http://www.sciencedirect.com/science/article/pii/S0168822704001317
DOI
10.1016/j.diabres.2004.05.001
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Rae(김경래)
Kim, Yoo Mee(김유미)
Ahn, Chul Woo(안철우) ORCID logo https://orcid.org/0000-0003-3733-7486
Lee, Hyun Chul(이현철)
Lim, Sung Kil(임승길)
Cha, Bong Soo(차봉수) ORCID logo https://orcid.org/0000-0003-0542-2854
Huh, Kap Bum(허갑범)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151148
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