Micronized fenofibrate normalizes the enhanced lipidemic response to a fat load in patients with type 2 diabetes and optimal glucose control.
This study evaluated the postprandial (PP) response to an oral fat load in 28 male patients with type 2 diabetes (mean HbA1c of 5.1%), all receiving metformin and performing physical exercise, compared with healthy subjects. The effects of micronized fenofibrate (200 mg once daily) on triglycerides (TG) and retinyl palmitate (RP) responses, lipoprotein mass concentrations, post-heparin lipase activities and coagulation factors were investigated after a 16-week double-blind, placebo-controlled period. Higher and delayed TG response after the oral fat load (P<0.001) corresponding to increases in both intestinally and endogenous TG-rich lipoproteins and lower lipoprotein lipase (LPL) activity 30 and 60 min post-heparin injection (P<0.05) were observed in the patients as compared with controls. Fasting PAI-1 activity, 6 h PP Factor VII and PAI-1 activities were higher in patients (P=0.036, P=0.032 and P=0.017, respectively). After fenofibrate treatment, TG and RP responses and peak LPL activity were no more significantly different from controls at baseline. Compared with placebo, fasting TG-rich lipoproteins and HDL(3) mass concentrations were significantly lower and higher, respectively; PP chylomicrons and very low density lipoprotein (VLDL) mass concentrations were lower; fasting and PP fibrinogen levels were significantly reduced after fenofibrate treatment. Diabetes control was unchanged throughout the study. Fenofibrate normalized the abnormal PP response and improved the fasting lipoprotein abnormalities in patients with type 2 diabetes and optimal glucose control.
Cavallero
Elisabeth
E
Service de Médecine Interne, Nutrition, Métabolisme lipidique, CHU Henri-Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France.
Dachet
Christiane
C
Assadolahi
Farideh
F
Martin
Claude
C
Navarro
Nicole
N
Ansquer
Jean-Claude
JC
Corda
Christophe
C
Foucher
Christelle
C
Juhan-Vague
Irene
I
Jacotot
Bernard
B
D000328:Adult; D001055:Apolipoproteins B / Q000097:blood; D001645:Biguanides / Q000627:therapeutic use*; D015243:Cholesterol, VLDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D004041:Dietary Fats; D004311:Double-Blind Method; D011345:Fenofibrate / Q000627:therapeutic use*; D006442:Glycated Hemoglobin; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D013453:Sulfonylurea Compounds / Q000627:therapeutic use*; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood*
D001055:Apolipoproteins B; D001645:Biguanides; D015243:Cholesterol, VLDL; D004041:Dietary Fats; D011345:Fenofibrate; D006442:Glycated Hemoglobin; D000960:Hypolipidemic Agents; D013453:Sulfonylurea Compounds; D014280:Triglycerides