Genetic risk factors and the anti atherosclerotic effect of pioglitazone on carotid atherosclerosis of subjects with type 2 diabetes-a retrospective study-

Aim: pioglitazone,an agonist of peroxisome proliferator-activated receptor y,showed various anti- atherosclerotic effects on type 2 diabetic patients. this retrosp ective study was done to ascertain which risk factor(s) associate with anti-atherosclerotic effects of pioglitazone. methods: we enrolled 160 diabetic patients treated through diet only and 62 treated with pioglitazone and annually evaluated carotid maximum (maximt) and averaged intima-media thickness (aveimt) for 2 years. we analyzed the relation of 99 single-nucleotide polymorphisms (snp) as well as conventional risk factors with the progression or regression of carotid atherosclerosis. results: the d allele of the angiotensin-converting enzyme (ace) gene and 677 allele of the methyl-lene-tetrahydrofolate reductase (mthfr) gene showed a significant association with increases in maximt among the diabetic subjects treated through diet only. the pioglitazone-treated carriers of the d allele showed an attenuation of maximt as compared with the diet-treated carriers. the pio-glitazone-treated carriers of the 677t allele carriers showed a significant attenuation of maximt compared with the diet-treated carriers. conclusions: pioglitazone may exert anti-atherosclerotic effects on type 2 diabetics carrying the ace gene's d allele and/or mthfr gene's 677t allele,who showed a progression of carotid atherosclerosis without the drug.