Increased high-density lipoprotein cholesterol predicts the pioglitazone-mediated reduction of carotid intima-media thickness progression in patients with type 2 diabetes mellitus.

Description

In the CHICAGO (Carotid Intima-Media Thickness in Atherosclerosis Using Pioglitazone) study, the effects of pioglitazone and glimepiride in the reduction of carotid intima-media thickness (CIMT) were measured in patients with type 2 diabetes. Pioglitzone treatment for 72 weeks was shown to significantly improve the cardiometabolic risk profile of participants and reduce CIMT. In these post-hoc analyses of the CHICAGO trial, Davidson et al. sought to determine whether changes in HDL cholesterol induced with pioglitazone treatment predicted changes in CIMT. After taking into account on-treatment values of cardiometabolic risk factors at 24 weeks, changes in HDL cholesterol and insulin levels had a significant effect on treatment response magnitude with regard to CIMT. It was also reported that irrespective of treatment, increased HDL cholesterol levels at 24 weeks were a significant predictor of reduced rates of CIMT progression. Based on these findings, the authors suggested that the extent to which pioglitazone improves surrogate measures of atherosclerosis could be mediated by its HDL cholesterol-raising properties.