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Pioglitazone improves the cardiovascular profile in patients with uncomplicated systemic lupus erythematosus: a double-blind randomized clinical trial

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  1. JG Juárez-Rojas1,2
  2. AX Medina-Urrutia1
  3. E Jorge-Galarza1
  4. NA Caracas-Portilla1
  5. R Posadas-Sánchez1
  6. GC Cardoso-Saldaña1
  7. MV Goycochea-Robles3
  8. LH Silveira4
  9. L Lino-Pérez5
  10. J Mas-Oliva6
  11. O Pérez-Méndez7
  12. C Posadas-Romero1⇓

  1. 1Endocrinology Department, National Institute of Cardiology “Ignacio Chávez”, Mexico

  2. 2Doctorate Program of Biomedical Sciences from the National Autonomous University of Mexico, Mexico

  3. 3Clinical Epidemiology Research Unit, Number 1 Regional Hospital from the Mexican Institute of the Social Security, Carlos McGregor Sánchez Navarro, Mexico

  4. 4Rheumatology Department, National Institute of Cardiology “Ignacio Chávez”, Mexico

  5. 5Rheumatology Department, Mexican General Hospital, Mexico

  6. 6Cellular Physiology Institute, National Autonomous University of Mexico, Mexico

  7. 7Molecular Biology Department, National Institute of Cardiology “Ignacio Chávez”, Mexico
  1. Posadas-Romero Carlos, Juan Badiano 1, Seccion XVI, Tlalpan 14080, Mexico D.F. Email: cposadasr{at}yahoo.com

Objective: We studied the effect of pioglitazone on insulin levels, inflammation markers, high-density lipoprotein (HDL) composition and subclasses distribution, in young women with uncomplicated systemic lupus erythematosus (SLE).

Methods: This double-blind trial included 30 premenopausal women (30 ±8 years old) with SLE, who were randomized to pioglitazone (30 mg/day) or placebo treatment for 3 months. Plasma and HDL lipids were determined by colorimetric enzymatic assays, insulin by radioimmunometric assay, inflammation by immunonephelometry and HDL size and subclasses distribution by a native 4–30% polyacrylamide gradient gel electrophoresis.

Results: Compared with placebo, pioglitazone significantly increased HDL-cholesterol plasma levels (14.2%), reduced fasting insulin plasma levels (23.6%) and the homeostasis model assessment-insulin resistance (31.7%). C-reactive protein (70.9%) and serum amyloid A (34.9%) were also significantly reduced with the pioglitazone use, whereas the HDL particle size was increased (8.80 nm vs. 8.95 nm; p = 0.044) by changes in the distribution of HDL2b, HDL3b, and HDL3c subclasses. The change in HDL size correlated with a rise in free and cholesterol–ester content in the HDL particles.

Conclusion: Pioglitazone significantly enhanced insulin sensitivity, reduced inflammation, and modified HDL characteristics, suggesting a potential beneficial effect of this drug in patients with SLE with a risk to develop cardiovascular disease.

Trial registration: This trial is registered at ClinicalTrials.gov Protocol Registration System, with the number NCT01322308.

  • Received June 20, 2011.
  • Accepted August 4, 2011.
  • © The Author(s), 2011. Reprints and permissions: http://www.sagepub.co.uk/journalsPermissions.nav

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