two-hour postload plasma glucose and pigment epithelium-derived factor levels are markers of coronary artery inflammation in type 2 diabetic patients

We have previously found that pioglitazone attenuates inflammation in the left main trunk of coronary artery (lmt), evaluated as target-to-background ratio (tbr) by 18f-fluorodeoxyglucose-positron emission tomography/computed tomography (fdg-pet/ct) in patients with impaired glucose tolerance or type 2 diabetes. we assessed which clinical variables could predict the change in tbr in the lmt after 4-month add-on therapy with oral hypoglycemic agents (ohas). a total of 38 type 2 diabetic patients with carotid atherosclerosis who had already received ohas except for pioglitazone was enrolled. at baseline and 4 months after add-on therapy with pioglitazone or glimepiride, all patients underwent 75 g oral glucose tolerance test, blood chemistry analysis, and fdg-pet/ct. fasting plasma glucose, 30-, 60-, 90-, 120-minutes postload plasma glucose, hba1c, and lmt-tbr values were significantly decreased by add-on therapy, whereas high-density lipoprotein-cholesterol and adiponectin levels were increased. increased serum levels of pigment epithelium-derived factor (pedf), a marker of insulin resistance and non-use of aspirin at baseline could predict the favorable response of lmt-tbr to add-on therapy. moreover, δ120-minutes postload plasma glucose and δpedf were independent correlates of δlmt-tbr. our present study suggests that 120-minutes postload plasma glucose and pedf values be markers and potential therapeutic targets of coronary artery inflammation in type 2 diabetic patients. url: http://clinicaltrials.gov. unique identifier: nct00722631. new markers for diabetes and cad is on the horizon! two-hour postload plasma glucose and pigment epithelium derived factor are markers of coronary artery inflammation in type 2 diabetic patients.