Effect of acarbose, an alpha-glucosidase inhibitor, on serum lipoprotein lipase mass levels and common carotid artery intima-media thickness in type 2 diabetes mellitus treated by sulfonylurea.
OBJECTIVE
Previous reports indicate that serum lipoprotein lipase mass levels (LPL mass) and common carotid artery intima-media thickness (CCA-IMT) are independent predictors of atherosclerotic diseases. The aim of this study was to examine the effects of combination therapy of sulfonylurea and acarbose on LPL mass and CCA-IMT.


METHODS
Eighty-four patients with type 2 diabetes mellitus, who were treated with only sulfonylureas and showed CCA-IMT of more than 0.9 mm at baseline, were selected and randomly divided into two groups. One group was administered acarbose 300 mg/day for 12 months (acarbose group, n=41), and the other group was not administered acarbose (non-acarbose group, n=43).


RESULTS
After 12 months, a significant increase in LPL mass and a significant decrease in CCA-IMT were observed in the acarbose group (1.024 to 0.964 mm), but no significant changes were observed in the non-acarbose group. In a subgroup analysis of patients with HbA1c improved by 0.5% or more, the increase of LPL mass and decrease of CCA-IMT was significantly greater in the acarbose group than in the non-acarbose group although the changes in HbA1c were similar in two groups.


CONCLUSIONS
We concluded that reducing postprandial hyperglycemia might increase LPL mass levels and might be useful to prevent macroangiopathy in type 2 diabetic patients treated by sulfonylurea.
Oyama
Tomokazu
T
Department of Internal Medicine, Sakura Medical Center, School of Medicine, Toho University, Chiba, Japan.
Saiki
Atsuhito
A
Endoh
Kei
K
Ban
Noriko
N
Nagayama
Daizi
D
Ohhira
Masahiro
M
Koide
Nobukiyo
N
Miyashita
Yoh
Y
Shirai
Kohji
K
D020909:Acarbose / Q000494:pharmacology*; D000368:Aged; D001835:Body Weight; D002339:Carotid Arteries / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D065089:Glycoside Hydrolase Inhibitors; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology; D008071:Lipoprotein Lipase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D013453:Sulfonylurea Compounds / Q000494:pharmacology*; D017539:Tunica Intima / Q000473:pathology*; D017540:Tunica Media / Q000473:pathology*
D065089:Glycoside Hydrolase Inhibitors; D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds; D008071:Lipoprotein Lipase; D020909:Acarbose