Metabolic effects of pioglitazone and sodium-glucose cotransporter 2 inhibitors in familial partial lipodystrophy
Acta Diabetologica, vol.63, no.3, pp.497-505, 2026 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 63 Issue: 3
- Publication Date: 2026
- Doi Number: 10.1007/s00592-025-02633-w
- Journal Name: Acta Diabetologica
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE
- Page Numbers: pp.497-505
- Keywords: Lipodystrophy, PPARG agonists, Sodium-Glucose Cotransporter 2, Inhibitors
- Dokuz Eylül University Affiliated: Yes
Abstract
Objective: We aimed to evaluate the potential metabolic benefits of pioglitazone, a PPARG agonist, and sodium-glucose cotransporter 2 (SGLT2) inhibitors in patients with familial partial lipodystrophy (FPLD). Methods: This retrospective medical chart study included 38 adult patients with FPLD (18 treated with pioglitazone and 20 with SGLT2 inhibitors). Results: Treatment with pioglitazone reduced HbA1c from 8.6% (6.2–9.2) to 7.0% (5.9–8.8) at month 6 (p = 0.004) and 7.0% (6.1–8.7) at month 12 (p = 0.107). Triglycerides decreased by 25% (6–55%) at month 6 (p = 0.001) and 16% (4–44%) at month 12 (p = 0.008). A modest reduction in ALT was observed at month 12 (p= 0.046). Treatment with SGLT2 inhibitors reduced HbA1c from 8.7% (7.9–10.2) at baseline to 8.1% (7.4–9.4) at month 6 (p = 0.003) and 7.9% (7.3–8.9) at month 12 (p = 0.003). Median triglyceride levels decreased by 11% (0–33%) at month 6 (p = 0.013), while changes at month 12 were not significant. No meaningful changes were observed in weight, ALT, or AST. Conclusions: We observed modest metabolic improvements following treatment with pioglitazone and SGLT2 inhibitors in patients with FPLD.