The effect of thiazolidinediones on leucocytes in type II diabetic patients

Objective: To investigate the effect of thiazolidinediones, which are peroxisome proliferator-activated receptor gamma (PPARgamma) ligands used to treat diabetes mellitus. In particular our study is interested in the effect of rosiglitazone in the number of leucocytes knowing that it causes reduction of haemoglobin and haematocrit mainly due to water retention.

Materials – methods: In 25 patients,12 men and 13 women, already under insufficient hypoglycaemic control (mainly under glibenclamide) 4mg/die of rosiglitazone were added.5 of them had positive hypertensive anamnesis and in 8 hypertension was newly diagnosed. No one was under pharmacologic control. Plasma leucocytes were counted in every patient at the beginning of our study and after 6 months. A control group of 25 more diabetic patients under their usual therapy was included in the study.

Results: Average leucocytes number at the beginning of the study was 7216±452×10⁶/L, while 6 month later was reduced to 6480±352×10⁶/L, (p<0,05). The control group did not show significant variation.Corresponding leucocites level was of 7186±442×10⁶/L initially and 7212±456×10⁶/L after 6 months.It is remarkable that not any patient developed abnormally low leucocytes level nor showed correlated symptoms while patients under rosiglitazone recorded significant weight increase (from 76,8±2,2 initially to 78,7±2,5 Kgr 6 months after). Bioreactor analysis recorded total body water increase from 39,5±1,4 to 41,3±1,6 L.

Conclusions: It has been concluded that additional rosiglitazone in type II diabetic and hypertensive patients is connected to leucocytes decrease. Although water retention can be taken as a fact, further effect of thiazolidinediones on leucocytes must be deeply investigated.