Treatment with combination of pioglitazone and glimepiride decreases levels of chemerin and asymmetric dimethylarginine (ADMA) in obese type 2 diabetic patients

Abstract

Chemerin is an adipokine that plays a crucial role in adipocyte differentiation and development, as well as in glucose and lipid metabolism. High levels of asymmetric dimethylarginine (ADMA), a naturally occurring product of metabolism, inhibit nitric oxide (NO) synthesis and are related to endothelial dysfunction. The aim of this study was to investigate the effect of vildagliptin therapy and the combination of pioglitazone and glimepiride on the levels of NO, ADMA, and chemerin in diabetic patients. The study was conducted on 140 subjects, including 40 apparently healthy subjects, and 100 type 2 diabetic obese patients; 50 of them were treated with vildagliptin, and the other 50 patients revived combination of pioglitazone and glimepiride, both groups were treated for 12 months. For all participants, the levels of fasting blood glucose (FBG), fructosamine, HbA1c, lipid profile, ADMA, NO, and chemerin were determined. The levels of those parameters were compared before and after treatment. In both treated groups, levels of FBG, fructosamine, HbA1c, TC, and LDL-C decreased after treatment. Levels of chemerin and ADMA decreased significantly after treatment, whereas the levels of NO increased compared to the baseline values. Additionally, levels of chemerin and ADMA in the group treated with combination of pioglitazone and glimepiride were significantly lower compared to the group treated with vildagliptin. In conclusion, treatment with combination of pioglitazone and glimepiride had a favorable effect on chemerin and ADMA levels in obese type 2 diabetic patients.