Reduction in hematocrit and hemoglobin following pioglitazone treatment is not hemodilutional in type II diabetes mellitus

R. Berria, L. Glass, A. Mahankali, Y. Miyazaki, A. Monroy, Elena Anna De Filippis, K. Cusi, E. Cersosimo, R. A. DeFronzo, A. Gastaldelli

Research output: Contribution to journalArticle

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Abstract

Peripheral edema, mild weight gain, and anemia are often observed in type II diabetic patients treated with thiazolidinediones (TZDs). Small decreases in hemoglobin (Hb) and hematocrit (Hct) appear to be a class effect of TZDs and are generally attributed to fluid retention, although experimental data are lacking. We analyzed 50 patients with type II diabetes mellitus undergoing either placebo or pioglitazone (PIO, 45 mg/day) for 16 weeks. Before and after therapy, we measured Hb/Hct and used 3H2O and bioimpedance to quantitate total body water (TBW), extracellular water, and fat-free mass. The majority (89%) of the increment in body weight was accounted for by increased body fat. Hb and Hct fell significantly in the PIO group (-0.9±0.2 g/dl, -2.4±0.5%, both P<0.0001), without change in TBW. A decline in white blood cell (-0.8±0.1 × 10 3/mm3, P<0.0001) and platelet (-15±6 × 103/mm3, P<0.02) counts was seen after PIO. In conclusion, the small decreases in Hb/Hct observed after 16 weeks of PIO treatment cannot be explained by an increase in TBW. Other causes, such a mild marrow suppressive effect, should be explored.

Original languageEnglish (US)
Pages (from-to)275-281
Number of pages7
JournalClinical Pharmacology and Therapeutics
Volume82
Issue number3
DOIs
StatePublished - Sep 2007
Externally publishedYes

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pioglitazone
Hematocrit
Type 2 Diabetes Mellitus
Body Water
Hemoglobins
Thiazolidinediones
Therapeutics
Weight Gain
Adipose Tissue
Anemia
Edema
Leukocytes
Blood Platelets
Bone Marrow
Fats
Placebos
Body Weight
Water

ASJC Scopus subject areas

  • Pharmacology

Cite this

Reduction in hematocrit and hemoglobin following pioglitazone treatment is not hemodilutional in type II diabetes mellitus. / Berria, R.; Glass, L.; Mahankali, A.; Miyazaki, Y.; Monroy, A.; De Filippis, Elena Anna; Cusi, K.; Cersosimo, E.; DeFronzo, R. A.; Gastaldelli, A.

In: Clinical Pharmacology and Therapeutics, Vol. 82, No. 3, 09.2007, p. 275-281.

Research output: Contribution to journalArticle

Berria, R, Glass, L, Mahankali, A, Miyazaki, Y, Monroy, A, De Filippis, EA, Cusi, K, Cersosimo, E, DeFronzo, RA & Gastaldelli, A 2007, 'Reduction in hematocrit and hemoglobin following pioglitazone treatment is not hemodilutional in type II diabetes mellitus', Clinical Pharmacology and Therapeutics, vol. 82, no. 3, pp. 275-281. https://doi.org/10.1038/sj.clpt.6100146
Berria, R. ; Glass, L. ; Mahankali, A. ; Miyazaki, Y. ; Monroy, A. ; De Filippis, Elena Anna ; Cusi, K. ; Cersosimo, E. ; DeFronzo, R. A. ; Gastaldelli, A. / Reduction in hematocrit and hemoglobin following pioglitazone treatment is not hemodilutional in type II diabetes mellitus. In: Clinical Pharmacology and Therapeutics. 2007 ; Vol. 82, No. 3. pp. 275-281.
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