(Des)controle de parâmetros clínicos e antropométricos em indivíduos com doença arterial coronária

Estudo de corte transversal que avaliou parâmetros clínicos e antropométricos em 100 indivíduos com doença arterial coronária, atendidos em um ambulatório de cardiologia preventiva em um hospital público, em Salvador/BA. Na coleta de dados empregou-se entrevista, avaliação clínica e laboratorial. Os resultados foram analisados em médias e percentuais. Predominou homens, faixa etária <60 anos, raça/cor negra casado(a)s, baixa escolaridade e renda, indivíduos sem ocupação e com diagnóstico de infarto do miocárdio. A maioria relatou hipertensão arterial, dislipidemia, sedentarismo, abandono do tabagismo e da bebida alcoólica. Todas as mulheres e 82% dos homens tinham circunferência abdominal aumentada, 19% glicemia casual >200 mg/dl, 36% sobrepeso, 28% obesidade, 65% algum estágio de hipertensão arterial, 65% HDL-C baixo e 43% estava com colesterol total alto. Em indivíduos de alto risco cardiovascular e condições socioeconômicas deficitárias constatou-se o descontrole de vários fatores de risco cardiovascular, demandando práticas de cuidar efetivas para o controle da doença.

Risco cardiovascular em profissionais de saúde de serviços de atendimento pré-hospitalar

Avaliar os fatores de risco cardiovascular, com ênfase na hipertensão, e estratificá-los de acordo com o Escore de Risco de Framingham (ERF). Estudo com 154 profissionais que atuavam em aten-dimento pré-hospitalar na cidade de São Paulo e rodovia Br-116. Foi considerado significante o valor de p<0,05. A prevalência de hipertensão foi de 33%, sendo que 20,1% eram tabagistas, 47% ingeriam bebidas alcoólicas, 64% eram sedentários, 66% apresentaram obesidade/sobrepeso e 70% cintura abdominal alterada, glicemia>110mg/dL- 11%, colesterol total>200mg/dL- 36%, LDL-c>130mg/dL- 33%, HDL-c<60mg/dL- 89%, triglicérides>150mg/dL- 30% e proteína C reativa>0,5mg/dL- 16%. O ERF foi médio em 10,3% e alto em 1,3%. Na análise de regressão logística verificou-se que a hipertensão associou-se com as variáveis: HDL-c (odds ratio: 0,257) e ERF (odds ratio: 23,159). Houve forte associação entre ERF e hipertensão. Os dados chamam a atenção, por se tratar principalmente de profissionais da área da saúde relativamente jovens.

Impact of Roux-en-Y gastric bypass on lipid and inflammatory profiles

Objective: To evaluate the behavior of acute phase proteins and lipid profile in patients undergoing Roux-en-Y gastric bypass. Methods : We conducted a prospective study, consisting of three moments: M1 - preoperative (24 hours before surgery); M2 - 30 days after surgery; and M3 - 180 days after surgery. We carried measured height and BMI, as well as determined the concentrations of acute phase proteins (C-reactive protein (CRP), albumin and Alpha-1-acid glycoprotein) and total cholesterol, LDL-c, HDL-c and triacylglycerol. Results : participants comprised 25 individuals, with a mean age of 39.28 ± 8.07, 72% female. At all times of the study there was statistically significant difference as for weight loss and BMI. We found a significant decrease in CRP concentrations between the moments M1 and M3 (p = 0.041) and between M2 and M3 (p = 0.018). There was decrease in Alpha-1-GA concentrations between M1 and M2 (p = 0.023) and between M1 and M3 (p = 0.028). The albumin values increased, but did not differ between times. Total cholesterol and triacylglycerol decreased significantly ay all times. LDL-c concentrations decreased and differed between M1 and M2 (p = 0.001) and between M1 and M3 (p = 0.001). HDL-c values increased, however only differing between M1 and M2 (p = 0.050). Conclusion : Roux-en-Y gastric bypass promoted a decrease in plasma concentrations of CRP and Alpha-1-acid glycoprotein, improving lipid and inflammatory profiles.

Efeitos do implante subdérmico de acetato de nomegestrol sobre o metabolismo de carboidratos, lipoproteínas séricas e função hepática

Objetivos: avaliar variações de peso corporal, pressão arterial, glicemia em jejum, HbA1C, insulina, colesterol total, HDL-C, LDL-C, triglicérides, TGO, TGP, GGT e bilirrubina em mulheres usuárias de um implante único, subdérmico, de Silástico, contendo 55 mg (±10%) de acetato de nomegestrol, durante dois anos. Métodos: dezoito voluntárias saudáveis e em idade reprodutiva, que desejavam fazer uso de anticoncepcionais e não apresentavam contra-indicações para o uso de contracepção hormonal, participaram deste estudo. Todas as mulheres foram avaliadas antes do início do tratamento e a seguir, acompanhadas por um período de dois anos. Ao final do primeiro ano, as cápsulas foram retiradas e novas cápsulas foram inseridas. Resultados: o peso corporal aumentou de 54,9 ± 1,5 kg na admissão para 55,3 ± 2,0 kg no 12º mês de uso (p<0,05), e para 56,0 ± 2,7 kg no 24º mês de uso. Registrou-se discreto aumento da pressão arterial, tanto sistólica quanto diastólica, no mês 12 (p<0,01). No mês 24, a pressão arterial não era significativamente diferente dos valores de admissão. Todos os valores estiveram dentro dos limites da normalidade. Insulina, HbA1C, LDL-C e GGT permaneceram inalterados durante os vinte e quatro meses de uso do implante. Diminuição significativa do colesterol total (p<0,05) foi observada no 3º mês e de HDL-C (p<0,01) no 6º mês. Observou-se aumento significativo de triglicérides (p<0,05) apenas no 12º mês. Todas as alterações de lipoproteínas foram inconsistentes, e os valores estiveram dentro dos limites da normalidade. Aumentos significativos dos níveis de glicemia em jejum (p<0,05 e p<0,01) foram observados respectivamente no 3º e no 6º mês. Diminuições significativas da TGO (p<0,05, p<0,01 e p<0,05) foram observadas respectivamente no 6º, 18º e 24º mês e da TGP (p<0,05) no 18º mês. Somente se observou aumento significativo de bilirrubina (p<0,05) no 3º mês de uso do implante. Todas estas variações permaneceram dentro dos limites da normalidade. Conclusões: esses resultados demonstraram que, dentro dos limites da normalidade, as variações de glicemia em jejum não se correlacionam às alterações dos níveis de insulina. As alterações discretas em lipoproteínas séricas, TGO, TGP e bilirrubina foram transitórias. Não foram observados efeitos clínicos em lipoproteínas, metabolismo de carboidratos, níveis de insulina e função hepática entre as usuárias por dois anos.

Aspectos clínicos e metabólicos de mulheres na pós-menopausa tratadas com tibolona

Objetivos: analisar a repercussão da tibolona sobre os sintomas do climatério e sobre algumas variáveis clínicas e metabólicas. Métodos: foram avaliadas 34 pacientes na pós-menopausa que foram submetidas ao tratamento com tibolona na dose de 2,5 mg/dia por 48 semanas. Foram analisados os seguintes parâmetros: peso, pressão arterial e perfis lipídico e lipoprotéico, representados pelos níveis de colesterol total, HDL-c, LDL-c, VLDL-c e triglicerídeos. Resultados: melhora relevante da sintomatologia do climatério foi demonstrada por decréscimo significativo do índice menopausal de Kupperman (p<0.001) e da freqüência média das ondas de calor (p<0.001). Estes efeitos foram observados já no primeiro mês de tratamento, mantendo-se até o final do estudo. Houve decréscimo significante nos níveis de colesterol total, triglicerídeos e VLDL-c (p<0.001). Os níveis de LDL-c apresentaram discreta redução (não-significante). Os níveis de HDL-c mostraram decréscimo significante na 24ª semana de tratamento, mas retornaram aos níveis basais na 48ª semana. Não foram observadas modificações significantes no peso e pressão arterial. Os efeitos colaterais relatados incluíram sangramento vaginal, náusea e edema, todos temporários e de intensidade leve. Conclusão: a tibolona representa uma opção para o tratamento dos sintomas climatéricos em mulheres na pós-menopausa, sem alterações relevantes no perfil lipídico e lipoprotéico.

Efeito de doses elevadas de tibolona sobre o peso corporal e perfil lipídico de ratas ooforectomizadas

OBJETIVO: avaliar o efeito do uso prolongado de alta dose de tibolona na variação do peso corporal e no perfil lipídico de ratas ooforectomizadas. MÉTODOS: foram utilizadas 15 ratas Wistar, pesando 250 g, que foram divididas aleatoriamente em dois grupos. O Grupo Experimental (n=9) recebeu diariamente 1 mg/dia de tibolona via oral. O Grupo Controle (n=6) recebeu diariamente solução de carboximetilcelulose a 0,5%, por gavagem, em volume de 0,5 mL/rata. Foi realizada ooforectomia bilateral 30 dias antes do início do experimento. No dia 0 do experimento, os animais começaram a receber os respectivos tratamentos por 20 semanas. O peso corporal foi controlado semanalmente e o consumo de ração foi medido a cada três a quatro dias ao longo do experimento, estabelecendo o consumo médio/dia por animal. Os resultados foram comparados pelo teste t de Student, com nível de significância de p<0,05. RESULTADOS: o Grupo Tibolona teve consumo de ração diário significativamente (p<0,001) menor (12,7±1,2 g), quando comparado ao Grupo Controle (14,5±1,4 g). Essa diferença também foi significativa em relação ao peso dos animais, uma vez que o Grupo Tibolona teve peso corporal inferior (p<0,001) ao longo do experimento, alcançando peso médio final de 215,6±9,3 versus 243,6±6,4 g no Grupo Controle. Com relação ao perfil lipídico, o Grupo Tibolona apresentou valores inferiores de colesterol total em comparação ao Grupo Controle (30,3 versus 78,6 mg/dL) mostrando diferença significativa (p<0,001). A dosagem de HDL-c também mostrou diferença significativa (p<0,001), com o Grupo Tibolona apresentando níveis inferiores ao Controle (9,0 versus 52,0 mg/dL). Quanto aos demais parâmetros bioquímicos analisados (LDL-c, VLDL-c e triglicerídeos), não houve diferença entre os grupos. CONCLUSÕES: A tibolona causa redução de HDL-c e colesterol total e tem efeito deletério sobre o peso corporal de ratas ooforectomizadas, que pode estar relacionado ao menor consumo de ração por esses animais.

Manifestações clínicas, bioquímicas, ultrassonográficas e metabólicas da síndrome dos ovários policísticos em adolescentes

OBJETIVO: Avaliar os parâmetros clínicos, ultrassonográficos, bioquímicos e as alterações metabólicas em adolescentes com síndrome dos ovários policísticos (SOP). MÉTODOS: Estudo retrospectivo realizado com 44 adolescentes entre 12 e 19 anos, com diagnóstico de SOP pelo Consenso de Rotterdam. As alterações metabólicas foram avaliadas de acordo com as recomendações da Federação Internacional de Diabetes, sendo consideradas: circunferência da cintura (CC) >percentil 90 (10-15 anos de idade) ou >80 cm (idade >16 anos); glicemia de jejum >100 mg/dL; triglicerídios >150 mg/dL; HDL <40 mg/dL, e pressão arterial >Hg 130/85 mm. RESULTADOS: A média de idade foi de 16,7±2,2 anos e da idade da menarca 11,8±1,4 anos. A irregularidade menstrual mais observada foi amenorreia (72,7%) seguida de oligomenorréia (27,3%); hirsutismo foi observado em 86,4% e acne em 56,8%. Ovários policisticos ao ultrassom observados apenas em 27,3%. A média do IMC foi de 30,3±6,6 kg/m². De acordo com o IMC, 52,3% das adolescentes eram obesas, 13,6% estavam com sobrepeso e 6,8% eram eutróficas. O aumento da circunferência da cintura (63,6%, 28/44) e a redução do HDL-C (34,1%, 15/44) foram as alterações metabólicas mais observadas. Triglicerídios aumentados foram observados em 27,3% (12/44), pressão arterial e aumento da glicemia de jejum alterada foram encontrados em 9,1% (4/44) e 4,5% (2/44) dos casos, respectivamente. Acantosis nigricans foi observada em 52,3% das adolescentes com SOP e a resistência insulinica encontrada em 62,8%. A sindrome metabólica foi identificada em seis adolescentes (13,6%), sendo todas obesas ou com sobrepeso. CONCLUSÃO: Entre as adolescentes com SOP do estudo, a irregularidade menstrual e o hirsutismo são as manifestações clínicas mais frequentes, enquanto os achados ultrassonográficos compatíveis com ovários policísticos são os menos prevalentes. A obesidade associada à resistência à insulina predispõe estas adolescentes à maior frequência de alterações metabólicas.

Cardiovascular risk in middle-aged breast cancer survivors: a comparison between two risk models

PURPOSE: It was to assess the risk of cardiovascular disease (CVD) in breast cancer survivors (BCS).METHODS: This cross-sectional study analyzed 67 BCS, aged 45 -65 years, who underwent complete oncological treatment, but had not received hormone therapy, tamoxifen or aromatase inhibitors during the previous 6 months. Lipid profile and CVD risk were evaluated, the latter using the Framingham and Systematic COronary Risk Evaluation (SCORE) models. The agreement between cardiovascular risk models was analyzed by calculating a kappa coefficient and its 95% confidence interval (CI).RESULTS: Mean subject age was 53.2±6.0 years, with rates of obesity, hypertension, and dyslipidemia of 25, 34 and 90%, respectively. The most frequent lipid abnormalities were high total cholesterol (70%), high LDL-C (51%) and high non-HDL-C (48%) concentrations. Based on the Framingham score, 22% of the participants had a high risk for coronary artery disease. According to the SCORE model, 100 and 93% of the participants were at low risk for fatal CVD in populations at low and high risk, respectively, for CVD. The agreement between the Framingham and SCORE risk models was poor (kappa: 0.1; 95%CI 0.01 -0.2) for populations at high risk for CVD.CONCLUSIONS: These findings indicate the need to include lipid profile and CVD risk assessment in the follow-up of BCS, focusing on adequate control of serum lipid concentrations.

Serum biochemistry of 4-day-old ostriches (Struthio camelus)

An analysis was made of 30 four-day-old ostriches to evaluate their protein, metabolite, mineral, and serum enzyme profiles, to correlate them with the birds' sex. The values obtained were: Total proteins 3.59±0.72g/dL, albumin 1.04±0.14g/dL, globulins 2.51±0.56g/dL, A:G ratio 0.43± 0.07, total cholesterol 615.10±101.15mg/dL, high density lipoprotein cholesterol (HDL-C) 132.72±20.33mg/dL, low density lipoprotein cholesterol (LDL-C) 454.93±90.81mg/dL, very low density lipoprotein cholesterol (VLDL-C) 27.45±9.96mg/dL, triglycerides 137.23±49.78mg/dL, uric acid 6.24±2.15mg/dL, urea 18.27±12.33mg/dL, creatinine 0.30±0.04mg/dL, total calcium 9.38± 0.76mg/dL, ionized calcium 7.17±0.64mg/dL, phosphorus 6.96±0.91mg/dL, Ca:P ratio 1.37±0.21, iron 24.74±13.02µg/dL, sodium 142.03±6.17mEq/L, chlorides 109.59± 4.99mEq/L, aspartate aminotransferase (AST) 200.67±31.42 U/L, alanine aminotransferase (ALT) 3.90±1.92 U/L, γ-glutamyltransferase (GGT) 1.18±0.73 U/L, alkaline phosphatase (ALP) 597.30± 231.36 U/L, and creatine kinase (CK) 2348.30±755.60 U/L. Males and females showed significant differences in total proteins, globulins, alkaline phosphatase, A:G ratio, and uric acid.

Six years of treatment with the HELP system of a patient with familial hypercholesterolemia

The purpose of the present report is to demonstrate the long-term efficacy and safety of heparin-induced extracorporeal lipoprotein precipitation (HELP) of LDL-c and fibrinogen in the management of familial hypercholesterolemia. From June 1992 to June 1998 a 22-year-old young male patient with familial hypercholesterolemia (double heterozygote for C660X and S305C) resistant to medication and diet and with symptomatic coronary artery disease (angina) was treated weekly with 90-min sessions of the HELP system. The patient had also been previously submitted to right coronary artery angioplasty. The efficacy of the method was evaluated by comparing the reduction of total cholesterol, LDL-c and fibrinogen before and after the sessions and before and after initiation of the study (data are reported as averages for each year). During the study, angina episodes disappeared and there were no detectable adverse effects of the treatment. Total cholesterol (TC), fibrinogen, and LDL-c decreased significantly after each session by 59.6, 66.1 and 64%, respectively. HDL-c showed a nonsignificant reduction of 20.4%. Comparative mean values pre- and post-treatment values in the study showed significant differences: TC (488 vs 188 mg/dl), LDL-c (416.4 vs 145 mg/dl), and fibrinogen (144.2 vs 57.4 mg/dl). There was no significant change in HDL-c level: 29.4 vs 23 mg/dl. These data show that the HELP system, even for a long period of time, is a safe and efficient mode of treatment of familial hypercholesterolemia and is associated with disappearance of angina symptoms.

Cardiovascular risk factors in a population of Brazilian schoolchildren

Epidemiological and clinical evidence suggests that a judicious diet, regular physical activity and blood pressure (BP) monitoring must start in early childhood to minimize the impact of modifiable cardiovascular risk factors. This study was designed to evaluate BP and metabolic parameters of schoolchildren from Vitória, Espírito Santo State, Brazil, and correlate them with cardiovascular risk factors. The study was conducted on 380 students aged 10-14 years (177 boys, 203 girls) enrolled in public schools. Baseline measurements included body mass index, BP and heart rate. The students were submitted to exercise spirometry on a treadmill. VO2max was obtained from exercise testing to voluntary exhaustion. Fasting serum total cholesterol (TC), LDL-C, HDL-C, triglycerides (TG), and glucose were measured. Nine point nine percent of the boys and 11.7% of the girls were hypertensive or had pre-hypertensive levels. There was no significant correlation between VO2max and TC, LDL-C, or TG in prepubertal children, but a slight negative correlation was detected in post-pubertal boys for HDL-C and TG. In addition, children with hypertension (3.4%) or pre-hypertensive levels (6.6%) also had comorbidity for overweight and blood lipid abnormalities (14% for triglycerides, 44.7% for TC, 25.9% for LDL-C, 52% for low HDL-C). The present study shows for the first time high correlations between prehypertensive blood pressure levels and the cardiovascular risk factors high TC, high LDL-C, low HDL-C in schoolchildren. These are important for the formulation of public health policies and strategies.

Estrogen receptor 1 gene polymorphisms in premenopausal women: interaction between genotype and smoking on lipid levels

Estrogen has multiple effects on lipid and lipoprotein metabolism. We investigated the association between the four common single nucleotide polymorphisms in the estrogen receptor 1 (ESR1) gene locus, -1989T>G, +261G>C, IVS1-397T>C and IVS1-351A>G, and lipid and lipoprotein levels in southern Brazilians. The sample consisted in 150 men and 187 premenopausal women. The women were considered premenopausal if they had regular menstrual bleeding within the previous 3 months and were 18-50 years of age. Exclusion criteria were pregnancy, secondary hyperlipidemia due to renal, hepatic or thyroid disease, and diabetes. Smoking status was self-reported; subjects were classified as never smoked and current smokers. DNA was amplified by PCR and was subsequently digested with the appropriate restriction enzymes. Statistical analysis was carried out for men and women separately. In the study population, major allele frequencies were _1989*T (0.83), +261*G (0.96), IVS1-397*T (0.58), and IVS1-351*A (0.65). Multiple linear regression analyses indicated that an interaction between +261G>C polymorphism and smoking was a significant factor affecting high-density lipoprotein cholesterol (HDL-C) levels (P = 0.028) in women. Nonsmoking women with genotype G/C of +261G>C polymorphism had mean HDL-C levels higher than those with G/G genotype (1.40 ± 0.33 vs 1.22 ± 0.26 mmol/L; P = 0.033). No significant associations with lipid and lipoprotein levels in women and men were detected for other polymorphisms. In conclusion, the +261G>C polymorphism might influence lipoprotein and lipid levels in premenopausal women, but these effects seem to be modulated by smoking, whereas in men ESR1 polymorphisms were not associated with high lipoprotein levels.

Normal flow-mediated vasodilatation of the brachial artery and carotid artery intima-media thickness in subclinical hypothyroidism

Subclinical hypothyroidism (SHT) is a disease for which exact therapeutic approaches have not yet been established. Previous studies have suggested an association between SHT and coronary heart disease. Whether this association is related to SHT-induced changes in serum lipid levels or to endothelial dysfunction is unclear. The aim of this study was to determine endothelial function measured by the flow-mediated vasodilatation of the brachial artery and the carotid artery intima-media thickness (IMT) in a group of women with SHT compared with euthyroid subjects. Triglycerides, total cholesterol, HDL-C, LDL-C, apoprotein A (apo A), apo B, and lipoprotein(a) were also determined. Twenty-one patients with SHT (mean age: 42.4 ± 10.8 years and mean thyroid-stimulating hormone (TSH) levels: 8.2 ± 2.7 µIU/mL) and 21 euthyroid controls matched for body mass index, age and atherosclerotic risk factors (mean age: 44.2 ± 8.5 years and mean TSH levels: 1.4 ± 0.6 µIU/mL) participated in the study. Lipid parameters (except HDL-C and apo A, which were lower) and IMT values were higher in the common carotid and carotid bifurcation of SHT patients with positive serum thyroid peroxidase antibodies (TPO-Ab) (0.62 ± 0.2 and 0.62 ± 0.16 mm for the common carotid and carotid bifurcation, respectively) when compared with the negative TPO-Ab group (0.55 ± 0.24 and 0.58 ± 0.13 mm, for common carotid and carotid bifurcation, respectively). The difference was not statistically significant. We conclude that minimal thyroid dysfunction had no adverse effects on endothelial function in the population studied. Further investigation is warranted to assess whether subclinical hypothyroidism, with and without TPO-Ab-positive serology, has any effect on endothelial function.

Prevalence of metabolic syndrome and its association with educational inequalities among Brazilian adults: a population-based study

The present study estimated the prevalence of metabolic syndrome (MS) according to the criteria established by the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) and the International Diabetes Federation (IDF) and analyzed the contribution of social factors in an adult urban population in the Southeastern region of Brazil. The sample plan was based on multistage probability sampling according to family head income and educational level. A random sample of 1116 subjects aged 30 to 79 years was studied. Participants answered a questionnaire about socio-demographic variables and medical history. Fasting capillary glucose (FCG), total cholesterol, high-density lipoprotein cholesterol (HDL-C), and triglycerides were determined and all non-diabetic subjects were submitted to the 75-g oral glucose tolerance test. Body mass index (BMI, kg/m²), waist circumference and blood pressure (BP) were determined. Age- and gender-adjusted prevalence of MS was 35.9 and 43.2% according to NCEP-ATPIII and IDF criteria, respectively. Substantial agreement was found between NCEP-ATPIII and IDF definitions. Low HDL-C levels and high BP were the most prevalent MS components according to NCEP-ATPIII criteria (76.3 and 59.2%, respectively). Considering the diagnostic criteria adopted, 13.5% of the subjects had diabetes and 9.7% had FCG ≥100 mg/dL. MS prevalence was significantly associated with age, skin color, BMI, and educational level. This cross-sectional population-based study in the Southeastern region of Brazil indicates that MS is highly prevalent and associated with an important social indicator, i.e., educational level. This result suggests that in developing countries health policy planning to reduce the risk of MS, in particular, should consider improvement in education.

Effects of rosiglitazone on serum paraoxonase activity and metabolic parameters in patients with type 2 diabetes mellitus

Human serum paraoxonase contributes to the anti-atherogenic effect of high-density lipoprotein cholesterol (HDL-C) and has been shown to protect both low-density lipoprotein cholesterol (LDL-C) and HDL-C against lipid peroxidation. We investigated the effects of rosiglitazone on paraoxonase activity and metabolic parameters in patients with type 2 diabetes mellitus [50 patients (30 males, 20 females); mean±SD age: 58.7±9.2 years, body mass index: 28.2±4.1'kg/m2], in whom glucose control could not be achieved despite treatment with metformin, sulphonylurea, and/or insulin. The patients were given 4'mg/day rosiglitazone for 3 months in addition to their usual treatment. Serum paraoxonase activity, malondialdehyde, homocysteine, and lipid profile were measured at the time of initiation and at the end of therapy with rosiglitazone. After rosiglitazone therapy, serum levels of HDL-C, apolipoprotein A-1, and paraoxonase activity increased significantly (P<0.05) and malondialdehyde, homocysteine, lipoprotein(a), and glucose levels decreased significantly (P<0.05), but no significant changes in levels of total cholesterol and apolipoprotein B were observed. Triglyceride levels also increased significantly (P<0.05). Rosiglitazone treatment led to an improvement in glycemic control and to an increase in paraoxonase activity and HDL-C levels. Although rosiglitazone showed favorable effects on oxidant/antioxidant balance and lipid profile, further studies are needed to determine the effect of rosiglitazone on cardiovascular risk factors and cardiovascular morbidity and mortality.