Abstract

Lukshmy M. Hettihewa*, Lalith P. Dharmasiri, Thilak P. Weerarathna and Imendra G. Kotapola

Analysis of pharmacological effect of pioglitazone on hepatic insulin sensitivity index (hISI), peripheral resistance (IR), body mass index (BMI), body weight (BW) and lipids in type II diabetes mellitus. Patients were treated with 30 mg of pioglitazone (PIO) daily and investigated for BW, BMI, FBS, fasting insulin (FI) and triglycerides (TG). hISI and IR were calculated by McAuley (McA), HOMA & QUICKI indices ISI equation. There was no significant difference in BMI, BW and TG after 3 months. There was a significant reduction in FI (37.58 ï?± 6.09 to 15.37 ï?± 3.28 mU/L), IR by McA (4.68 ï?± 0.25 to 6.18 ï?± 0.31) HOMA and QUICKI (17.51 ï?± 3.36 to 5.41 ï?± 1.57 & 0.27 ï?± 0.0 to 0.34 ï?± 0.01, p > 0.001). No significant correlation was observed between BMI or BW with IR indices before, but significant correlation developed between BMI with FI (r = 0.4, p > 0.05) and McA (r = 0.48, p = 0. 02) after 3 months. The reduction of hISI was significant and found a substantial positive association between hISI with BMI. Correlations between hISI with HOMA, QUICKI and McA were significant but no significant correlation was detected between TG, HOMA or QUICKI with BMI or BW before or after therapy in our study cohort. There was an improvement of both hepatic and peripheral insulin sensitivity with three months of PIO. Significant correlations between BMI vs. McA and FI but not with HOMA or QUICKI can be related to inclusion of TG in McA’s equation but not in other indices. Reduction of both hepatic and peripheral IR suggests effects of PIO on fat clearance from liver. We propose that reduction of IR is related to the TG metabolism possibly by clearance of VLDL-TGs and activation of lipoprotein lipase in plasma by PIO.