Pioglitazone decreases plasma angiotensin II concentration in type 2 diabetes

Aim: adipocytes express all components of the renin-angiotensin system (ras),and adipocyte ras regulates adipocyte differentiation and metabolism. plasma angiotensin ii (aii) is a putative marker of adipocyte ras production. the aim of this study was to investigate the effect of pioglitazone on plasma aii in type 2 diabetes (t2d). methods: fifty japanese subjects with t2d were randomly allocated to two groups. one group was administered pioglitazone 30 mg/day (pioglitazone group) and the other group was not given pioglitazone (control group) for 16 weeks. lipoprotein lipase mass in preheparin serum (lpl mass) was measured as an adipocyte-derived factor and a marker of insulin sensitivity. results: in the pioglitazone group,the mean hba1c decreased (p<0.0001),lpl mass increased (p<0.0001),and plasma aii decreased (p = 0.0007),whereas these parameters were unchanged in the control group. the change in plasma aii correlated negatively with the change in lpl mass (r = -0.312) in the pioglitazone group. in the pioglitazone group,the decrease in plasma aii was higher (p = 0.0002) and the increase in lpl mass tended to be higher (p = 0.0941) in the subgroup with higher baseline plasma aii than that with lower plasma aii. conclusions: the present study indicates that pioglitazone decreases plasma aii associated with an increase in lpl mass in t2d. the insulin-sensitizing effect of pioglitazone may be involved in suppressing adipocyte ras.