Effect of troglitazone on body fat distribution in type 2 diabetic patients.
Abstract
OBJECTIVE: Troglitazone was recently reported to specifically promote the differentiation of pre-adipocytes into adipocytes in vitro in subcutaneous fat only, indicating a relation to insulin-resistance-improving action of troglitazone. To expand on this finding, we investigated at the clinical level how long-term administration of troglitazone influences the body fat distribution in type 2 diabetic patients. RESEARCH DESIGN AND METHODS: Troglitazone (400 mg/day) was administered for 6 months to 30 type 2 diabetic patients whose glycemic control was poor. A total of 18 patients received diet therapy alone (in the single-treatment group, BMI 26.0 +/- 4.6, HbA1c 8.2 +/- 1.7%), and 12 patients concomitantly received glibenclamide (1.25-7.5 mg/day) (in the concomitant sulfonylurea group, BMI 25.4 +/- 4.7, HbA1c 9.2 +/- 1.2%). BMI, HbA1c, serum lipid level, and body fat distribution, which were determined by computed tomography (CT) scan at the umbilical level, were measured and compared before and after troglitazone treatment. RESULTS: During the 6-month troglitazone treatment, HbA1c levels decreased and BMI increased in both groups. As for body fat distribution in the single-treatment group, visceral fat area (VFA) decreased (from 118.3 +/- 54.3 to 101.1 +/- 50.8 cm2; P < 0.001), and subcutaneous fat area (SFA) increased (from 189.7 +/- 93.3 to 221.6 +/- 101.6 cm2; P < 0.001), resulting in a decrease in visceral/subcutaneous (V/S) ratio (from 0.74 +/- 0.48 to 0.50 +/- 0.32; P < 0.001). In the concomitant sulfonylurea group, VFA was unchanged (from 108.1 +/- 53.5 to 112.5 +/- 59.9 cm2), while SFA increased (from 144.6 +/- 122.0 to 180.5 +/- 143.5 cm2; P < 0.01), thereby decreasing the V/S ratio (from 0.91 +/- 0.46 to 0.77 +/- 0.44; P < 0.01). The serum triglyceride level and the area under glucose curve during the 75-g oral glucose tolerance test decreased significantly in the single-treatment group. CONCLUSIONS: According to our data, troglitazone appears to promote fat accumulation in the subcutaneous adipose tissue rather than in the visceral adipose tissue in mildly obese Japanese people with type 2 diabetes. This shift of energy accumulation from the visceral to subcutaneous adipose tissue may greatly contribute to the troglitazone-mediated amelioration of insulin resistance.
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Thiazolidinediones, which induce adipocyte differentiation, improve insulin sensitivity and increase fat deposition in the subcutaneous rather than the intra-abdominal fat compartment.
“the thiazolidinediones, which induce adipocyte differentiation [63], not only improve insulin sensitivity but also increase fat deposition in the subcutaneous rather than the intra-abdominal fat compartment [64, 65].”
From The relative contributions of insulin resistance and beta-cell dysfunction to the pathophysiology of type 2 diabetes (2003) · cites this paper as [65]
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- Authors
- Mori, Y., Murakawa, Y., Okada, K., Horikoshi, H., Yokoyama, J., Tajima, N., & Ikeda, Y.
- Affiliations
- Department of Internal Medicine, National Higashi-Utsunomiya Hospital, Tochigi, Japan.
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 1999-06-01
- Volume
- 22
- Issue
- 6
- Pages
- 908-912
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W1999236387
- Cited by
- 281
- References
- 0
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 5 · 2022: 3 · 2021: 3 · 2020: 2 · 2019: 5 · 2018: 2 · 2017: 5 · 2016: 3 · 2015: 8 · 2014: 9 · 2013: 5 · 2012: 5
- FWCI
- 7.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Peroxisome Proliferator-Activated Receptors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- troglitazone, type 2 diabetes, body fat distribution, visceral fat, subcutaneous adipose tissue, insulin resistance, glibenclamide, sulfonylureas, HbA1c, body mass index, adipogenesis, long-term drug therapy, serum lipids, glycemic control, dietary therapy
- MeSH terms
- Abdomen, Troglitazone, Adipose Tissue, Blood Glucose, Blood Pressure, Chromans, Diabetes Mellitus, Type 2, Drug Therapy, Combination, Female, Glyburide, Glucose Tolerance Test, Humans, Hypoglycemic Agents, Lipids, Male, Middle Aged, Skin, Thiazoles, Tomography, X-Ray Computed, Viscera, Body Mass Index, Thiazolidinediones
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