OBJECTIVE: To evaluate the effects of rosiglitazone (ROSI), an insulin-sensitizer, on endothelial function and endothelial activation markers in a group of non-diabetic subjects with metabolic syndrome. METHODS: A group of eighteen subjects (12 women, 6 men), mean age 41.2 ± 9.7 and BMI 37.8 ± 6.1 Kg/m², was treated with rosiglitazone 8 mg/day for 12 weeks. Another group of nine healthy subjects, mean age 26.1 ± 4.4 and BMI 21.7 ± 1.7 Kg/m², was studied at baseline to compare vasodilator response. Endothelial function was evaluated by venous occlusion plethysmography after intra-arterial infusions of acetylcholine (Ach) and sodium nitroprusside (SNP). The following were measured: glucose, insulin, lipids, fibrinogen, and high-sensitivity C-reactive protein (CRP). HOMA and Quicki indexes were calculated to quantify insulin resistance (IR). RESULTS: There was an improvement in insulin resistance, as evidenced by lower HOMA-R and higher QUICKI index, as well as a decrease in CRP and fibrinogen levels. Endothelium-dependent vasodilation also improved, as evidenced by greater increment in blood flow after Ach and greater decrement in vascular resistance. No difference in endothelium-independent vasodilation was noted. CONCLUSION: Rosiglitazone treatment reduced insulin resistance, fibrinogen, and CRP levels and improved endothelial function in non-diabetic subjects with metabolic syndrome. These data suggest that rosiglitazone plays a role in the regulation of endothelial function in patients at high cardiovascular risk.
Endothelium; metabolic syndrome; rosiglitazone
