Pilot Study of Pioglitazone and Exercise Training Effects on Basal Myocardial Substrate Metabolism and Left Ventricular Function in HIV-Positive Individuals with Metabolic Complications
Year: 2013
Type: article
Study design: Clinical Trial
Abstract: BACKGROUND: Individuals with HIV infection and peripheral metabolic complications have impaired basal myocardial insulin sensitivity that is related to left ventricular (LV) diastolic dysfunction. It is unknown whether interventions shown to be effective in improving peripheral insulin sensitivity can improve basal myocardial insulin sensitivity and diastolic function in people with HIV and peripheral metabolic complications. OBJECTIVE: In a pilot study, we evaluated whether the peroxisome proliferator-activated receptor-gamma (PPAR-γ) agonist pioglitazone or combined endurance and resistance exercise training improves basal myocardial insulin sensitivity and diastolic function in HIV+ adults with peripheral metabolic complications. DESIGN: Twenty-four HIV+ adults with metabolic complications including peripheral insulin resistance were randomly assigned to 4 months of pioglitazone (PIO; 30 mg/d) or supervised, progressive endurance and resistance exercise training (EXS; 90-120 min/d, 3 d/wk). Basal myocardial substrate metabolism was quantified by radioisotope tracer methodology and positron emission tomography (PET) imaging, and LV function was measured by echocardiography. RESULTS: Twenty participants completed the study. Neither PIO nor EXS resulted in a detectable improvement in basal myocardial insulin sensitivity or diastolic function. Post hoc analyses revealed sample sizes of more than 100 participants are needed to detect significant effects of these interventions on basal myocardial insulin sensitivity and function. CONCLUSIONS: PIO or EXS alone did not significantly increase basal myocardial insulin sensitivity or LV diastolic function in HIV+ individuals with peripheral metabolic complications.
Source: HIV Clinical Trials
DOI: 10.1310/hct1406-303
Institution: Washington University in St. Louis
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: National Institutes of Health, National Institute of Allergy and Infectious Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Research Resources, National Center for Advancing Translational Sciences, National Center for Complementary and Integrative Health
Awards: G1123597226, WASHINGTON UNIVERSITY AIDS CLINICAL TRIALS UNIT, G1565341982, G1578241593, WASHINGTON UNIVERSITY AIDS CLINICAL TRIALS UNIT, Yoga for the Management of HIV-Metabolic Syndromes, Diabetes Research & Training Center, G2051891711, G2135258891, G2199452652, G2743333773, EXERCISE AND PIOGLITAZONE FOR HIV CARDIOMETABOLIC SYNDROMES, G3563133777, G3732380844, G4467312596, A Resource for Biomedical Mass Spectrometry, Exercise and TZD Effects on Myocardial Substrate Metabolism and Function in HIV, G4621590637, Metabolic Abnormalities in HIV, Myocardial Function and FFA Metabolism in HIV Metabolic Syndrome, Washington University Institute of Clinical and Translational Sciences, Exercise & Pioglitazone for HIV-Metabolic Syndromes, G766674393, Washington University Institute of Clinical and Translational Sciences (UL1), G87705910, Washington University Nutrition Obesity Research Center, Diabetes Research Center, GENERAL CLINICAL RESEARCH CENTER
OpenAlex ID: W2066324068