Journal
ANNALS OF MEDICINE
Volume 46, Issue 1, Pages 18-23Publisher
TAYLOR & FRANCIS LTD
DOI: 10.3109/07853890.2013.853369
Keywords
Glutamine; lactate; lipoprotein; metabolomics; myocardium; NMR spectroscopy; positron emission tomography; type 2 diabetes mellitus; rosiglitazone
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Funding
- Academy of Finland
- University of Turku
- Turku University Hospital
- Abo Academy
- Sigrid Juselius Foundation
- Finnish Funding Agency for Technology and Innovation TEKES
- Strategic Research Funding from the University of Oulu
- Turku University Foundation
- University of Turku Combined Research Fund
- Medical Research Council [MC_UU_12013/1] Funding Source: researchfish
- MRC [MC_UU_12013/1] Funding Source: UKRI
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Introduction. Treatment with rosiglitazone, a peroxisome proliferator-activated receptor-gamma. agonist, in type 2 diabetic mellitus (T2DM) patients is under scrutiny because it affects adversely cardiovascular outcomes. In T2DM patients, with existing coronary heart disease, short-term treatment with rosiglitazone increases myocardial glucose uptake (MGU). Serum metabolic and lipoprotein subclass changes, which may be associated with this rosiglitazone-induced improvement, are unknown. Methods. Patients with both T2DM and coronary heart disease were separated into placebo (n = 26) and treatment (rosiglitazone 4-8 mg; n = 25) groups. After 16 weeks of treatment, serum NMR metabolomics was used to measure circulating low-molecular-weight metabolites and lipoprotein subclasses and lipids that are associated with T2DM before and after the treatment. Significant metabolic measure changes after rosiglitazone treatment were correlated to MGU values assessed with [F-18] fluorodeoxyglucose positron emission tomography. Results. Compared to placebo, the treatment significantly increased circulating glutamine and decreased lactate concentrations. Circulating lactate concentrations showed a significant inverse association with MGU after rosiglitazone treatment. Conclusion. In T2DM patients with existing coronary heart disease, short-term rosiglitazone treatment caused minor improvements in metabolism: serum lactate and glutamine concentrations changed, reflecting improvements in insulin sensitivity, and circulating lactate concentrations inversely correlated to increases in myocardial glucose uptake.
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