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Relationship between urinary sodium excretion and pioglitazone-induced edema.

Nakamura A, Osonoi T, Terauchi Y - J Diabetes Investig (2010)

Bottom Line: We analyzed these parameters before and after 8 weeks of administration of pioglitazone to female subjects with type 2 diabetes.When we evaluated whether a significant correlation was found between salt excretion and blood pressure, six patients showed such correlation and 20 patients did not.After 8 weeks of pioglitazone administration, five patients had developed edema, and, surprisingly, such correlation was not found in all five subjects.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology and Metabolism, Graduate School of Medicine, Yokohama City University, Yokohama.

ABSTRACT
To investigate the factors contributing to pioglitazone-induced edema, we analyzed sodium excretion and several clinical parameters before and after administration of pioglitazone. We analyzed these parameters before and after 8 weeks of administration of pioglitazone to female subjects with type 2 diabetes. When we evaluated whether a significant correlation was found between salt excretion and blood pressure, six patients showed such correlation and 20 patients did not. After 8 weeks of pioglitazone administration, five patients had developed edema, and, surprisingly, such correlation was not found in all five subjects. Salt excretion after administration of pioglitazone was significantly lower in subjects who developed edema and those who showed the correlation, and the hematocrit was significantly lower after administration in the subjects who showed the correlation, but not in the edema group. Pioglitazone-induced edema would be caused not only by fluid retention, but also by other factors, such as vascular permeability. (J Diabetes Invest, doi: 10.1111/ j.2040-1124.2010.00046.x, 2010).

No MeSH data available.


Related in: MedlinePlus

 Changes in (a) salt excretion and (b) hematocrit after administration of pioglitazone to three groups for 8 weeks: a group that had no correlation between salt excretion and blood pressure but had edema (group A: open diamonds), a group that had correlation but did not have edema (group B: filled triangles), and a group that had neither correlation nor edema (group C: filled diamonds). Bars indicate the mean of each group.
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f1:  Changes in (a) salt excretion and (b) hematocrit after administration of pioglitazone to three groups for 8 weeks: a group that had no correlation between salt excretion and blood pressure but had edema (group A: open diamonds), a group that had correlation but did not have edema (group B: filled triangles), and a group that had neither correlation nor edema (group C: filled diamonds). Bars indicate the mean of each group.

Mentions: The data of the 26 patients who satisfactorily completed the follow‐up examinations were included in the analysis. Baseline characteristics of all subjects are shown in Table 1. After 8 weeks of pioglitazone administration, five patients (19.2%) had developed edema, whereas 21 patients (80.8%) had not developed edema. There were no differences in baseline characteristics between the two groups before administration of pioglitazone (Table 2). Although salt excretion was similar in the two groups before administration of pioglitazone, it was significantly decreased by administration of pioglitazone in the subjects with edema (−1.16 ± 0.96 g; P < 0.05), but it was not changed in the subjects without edema (−0.27 ± 1.05 g). We therefore investigated the relationship between the correlation between salt excretion and blood pressure and the development of edema. Six patients (23%) showed such a correlation and 20 patients (77%) did not. There were no differences between the characteristics of the two groups, including salt excretion, before administration of pioglitazone (Table 3). As previously stated, five patients (19.2%) had developed edema, and, surprisingly and interestingly, all five subjects did not show a correlation between salt excretion and blood pressure, although the proportion was not statistically significant. We therefore divided the subjects into three groups based on the presence of a correlation between salt excretion and blood pressure and the development of edema; a group that had no correlation but had edema (group A), a group that had correlation but did not have edema (group B), and a group that had neither correlation nor edema (group C). The correlation coefficient between salt excretion and blood pressure was significantly higher in group B than in group A and C (P < 0.01). As shown in Figure 1, salt excretion after administration of pioglitazone was significantly lower than before pioglitazone administration in group A and group B (P < 0.05), but not group C, and the hematocrit was significantly lower after administration in group B (P < 0.05), but not in group A or group C (Figure 1). Although systolic blood pressure was not changed by administration of pioglitazone in these three groups, diastolic blood pressure was significantly decreased by administration of pioglitazone in group C, but not in group A or group B (Table 4). There were no differences in bodyweight gain (group A, 0.6 ± 1.7 kg; group B, 0.7 ± 0.6 kg; group C, 0.6 ± 0.7 kg) and the changes in HbA1c level (group A, −0.8 ± 0.8%; group B, −0.1 ± 0.2%; group C, −0.3 ± 0.3%) among the three groups, and there was no association of the changes in salt excretion with the changes in bodyweight after the treatment with pioglitazone (correlation coefficient = 0.15).


Relationship between urinary sodium excretion and pioglitazone-induced edema.

Nakamura A, Osonoi T, Terauchi Y - J Diabetes Investig (2010)

 Changes in (a) salt excretion and (b) hematocrit after administration of pioglitazone to three groups for 8 weeks: a group that had no correlation between salt excretion and blood pressure but had edema (group A: open diamonds), a group that had correlation but did not have edema (group B: filled triangles), and a group that had neither correlation nor edema (group C: filled diamonds). Bars indicate the mean of each group.
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4020723&req=5

f1:  Changes in (a) salt excretion and (b) hematocrit after administration of pioglitazone to three groups for 8 weeks: a group that had no correlation between salt excretion and blood pressure but had edema (group A: open diamonds), a group that had correlation but did not have edema (group B: filled triangles), and a group that had neither correlation nor edema (group C: filled diamonds). Bars indicate the mean of each group.
Mentions: The data of the 26 patients who satisfactorily completed the follow‐up examinations were included in the analysis. Baseline characteristics of all subjects are shown in Table 1. After 8 weeks of pioglitazone administration, five patients (19.2%) had developed edema, whereas 21 patients (80.8%) had not developed edema. There were no differences in baseline characteristics between the two groups before administration of pioglitazone (Table 2). Although salt excretion was similar in the two groups before administration of pioglitazone, it was significantly decreased by administration of pioglitazone in the subjects with edema (−1.16 ± 0.96 g; P < 0.05), but it was not changed in the subjects without edema (−0.27 ± 1.05 g). We therefore investigated the relationship between the correlation between salt excretion and blood pressure and the development of edema. Six patients (23%) showed such a correlation and 20 patients (77%) did not. There were no differences between the characteristics of the two groups, including salt excretion, before administration of pioglitazone (Table 3). As previously stated, five patients (19.2%) had developed edema, and, surprisingly and interestingly, all five subjects did not show a correlation between salt excretion and blood pressure, although the proportion was not statistically significant. We therefore divided the subjects into three groups based on the presence of a correlation between salt excretion and blood pressure and the development of edema; a group that had no correlation but had edema (group A), a group that had correlation but did not have edema (group B), and a group that had neither correlation nor edema (group C). The correlation coefficient between salt excretion and blood pressure was significantly higher in group B than in group A and C (P < 0.01). As shown in Figure 1, salt excretion after administration of pioglitazone was significantly lower than before pioglitazone administration in group A and group B (P < 0.05), but not group C, and the hematocrit was significantly lower after administration in group B (P < 0.05), but not in group A or group C (Figure 1). Although systolic blood pressure was not changed by administration of pioglitazone in these three groups, diastolic blood pressure was significantly decreased by administration of pioglitazone in group C, but not in group A or group B (Table 4). There were no differences in bodyweight gain (group A, 0.6 ± 1.7 kg; group B, 0.7 ± 0.6 kg; group C, 0.6 ± 0.7 kg) and the changes in HbA1c level (group A, −0.8 ± 0.8%; group B, −0.1 ± 0.2%; group C, −0.3 ± 0.3%) among the three groups, and there was no association of the changes in salt excretion with the changes in bodyweight after the treatment with pioglitazone (correlation coefficient = 0.15).

Bottom Line: We analyzed these parameters before and after 8 weeks of administration of pioglitazone to female subjects with type 2 diabetes.When we evaluated whether a significant correlation was found between salt excretion and blood pressure, six patients showed such correlation and 20 patients did not.After 8 weeks of pioglitazone administration, five patients had developed edema, and, surprisingly, such correlation was not found in all five subjects.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology and Metabolism, Graduate School of Medicine, Yokohama City University, Yokohama.

ABSTRACT
To investigate the factors contributing to pioglitazone-induced edema, we analyzed sodium excretion and several clinical parameters before and after administration of pioglitazone. We analyzed these parameters before and after 8 weeks of administration of pioglitazone to female subjects with type 2 diabetes. When we evaluated whether a significant correlation was found between salt excretion and blood pressure, six patients showed such correlation and 20 patients did not. After 8 weeks of pioglitazone administration, five patients had developed edema, and, surprisingly, such correlation was not found in all five subjects. Salt excretion after administration of pioglitazone was significantly lower in subjects who developed edema and those who showed the correlation, and the hematocrit was significantly lower after administration in the subjects who showed the correlation, but not in the edema group. Pioglitazone-induced edema would be caused not only by fluid retention, but also by other factors, such as vascular permeability. (J Diabetes Invest, doi: 10.1111/ j.2040-1124.2010.00046.x, 2010).

No MeSH data available.


Related in: MedlinePlus