Relationship Between Postprandial Triglyceride Level and Intima-Media Thickness of Carotid Artery after Troglitazone Treatment in Type 2 Diabetes

Recently it has been indicated that PPAR γ interacts with oxidized LDL, suggesting an important role of PPAR γ in pathogenesis of atherosclerosis. We have recently demonstrated that troglitazone, a PPAR γ agonist, has a potent inhibitory effect on intima-media thickness (IMT) in type 2 diabetes. There have been increasing evidences that postprandial triglyceridemia is related to atherosclerotic diseases. In order to investigate the relation between effects of PPAR γ activation, postprandial triglyceride and atherosclerosis, we examined the effect of troglitazone on postprandial triglyceride and IMT in type 2 diabetes. Troglitazone treatment for 9 months caused a decrease in IMT, postprandial triglycerides and HbAlc, whereas total cholesterol level was unchanged. However, there was no statistically significant association between a decrease in IMT and those in postprandial triglycerides or in HbAlc. The reduction in IMT was larger in the subjects with higher initial IMT than in those with lower initial IMT. These results indicate that 1) troglitazone has both an antiatherogenic action and a lowering effect on postprandial triglycerides in type 2 diabetes, and that 2) the mechanisms through which troglitazone shows antiatherogenic action are different from those through which it improves glycemic control or postprandial lipoprotein metabolism.