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To the Editor: Dr Mazzone and colleagues¹ showed that pioglitazone slowed progression of CIMT compared with glimepiride in patients with type 2 diabetes. The absolute change of CIMT was used as the primary end point instead of the number of cardiovascular events because CIMT is strongly associated with risk of future cardiovascular events.²

Microalbuminuria is an independent risk factor for cardiovascular disease in patients with diabetes.³ Moreover, a multivariate analysis that adjusted for a number of confounding factors, such as age, sex, blood pressure, body mass index, duration of diabetes, HbA_1c level, smoking status, plasma lipid levels, and use of angiotensin-converting enzyme inhibitors and statins, found that only the presence and degree of microalbuminuria were independently associated with CIMT.⁴ In patients with type 2 diabetes, CIMT values were significantly higher among those with microalbuminuria compared with those with normoalbuminuria (P = .001).⁴

Treatments that lower albuminuria have been associated with . . . [Full Text of this Article]

Yujiro Kida, MD, PhD; Tetsuji Sato, DMD, PhD
Department of Anatomy II
Tsurumi University
School of Dental Medicine
Yokohama, Japan

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Pioglitazone vs Glimepiride and Carotid Intima-Media Thickness
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JAMA. 2007;297(12):1315-1316.
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Pioglitazone vs Glimepiride and Carotid Intima-Media Thickness—Reply
Theodore Mazzone
JAMA. 2007;297(12):1316-1317.
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RELATED ARTICLE

Effect of Pioglitazone Compared With Glimepiride on Carotid Intima-Media Thickness in Type 2 Diabetes: A Randomized Trial
Theodore Mazzone, Peter M. Meyer, Steven B. Feinstein, Michael H. Davidson, George T. Kondos, Ralph B. D’Agostino, Sr, Alfonso Perez, Jean-Claude Provost, and Steven M. Haffner
JAMA. 2006;296(21):2572-2581.
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