Atherogenic lipoprotein phenotype in Type 2 diabetes: reversal with micronised fenofibrate

✍ Scribed by Michael D. Feher; Muriel Caslake; Julie Foxton; Alison Cox; Christopher J. Packard

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 77 KB
• Volume: 15
• Category: Article
• ISSN: 1520-7552
• DOI: 10.1002/(sici)1520-7560(199911/12)15:6<395::aid-dmrr65>3.0.co;2-n

✦ Synopsis

Background:

To assess the short-term effects of a micronised formulation of fenofibrate on lipids, lipoproteins and their composition, reflecting an atherogenic lipoprotein phenotype (alp), in patients with stable type 2 diabetes.

Methods:

Thirty-two (18 male, 14 female) patients with type 2 diabetes were randomised to a double-blind, placebo-controlled parallel group study after a 4-week diet run-in phase to a 12-week treatment period with either daily micronised fenofibrate 200 mg (lipantil micro((r))) or placebo.

Results:

Baseline mean lipid and lipoproteins were similar in both groups: total cholesterol (tc) 7.5 mmol/l, serum triglyceride (tg) 3. 1 mmol/l, hdl-cholesterol (hdl-c) 1.2 mmol/l, ldl-cholesterol (ldl-c) 4.7 mmol/l, and a predominance (52%) of small dense ldl-iii at concentration of 192 mg lipoprotein/100 ml, reflecting an alp. treatment with micronised fenofibrate resulted in significant changes in tc (-17%, p<0.001), serum tg (-44%, p<0.05), hdl-c (+20%, p<0.01), ldl-c (-22%, p<0.001), apo-b (-18%, p<0.05) and alterations in ldl subfraction masses (ldl-i +64%, p<0.05; ldl-ii +53%, p<0.05; ldl-iii -51%, p<0.001) resulting in ldl-iii comprising 28% of total ldl (p<0.001). in the placebo group the only significant changes were in tg (+21%, p<0.05) and apo-b (+9%, p<0.05).

Conclusions:

Micronised fenofibrate therapy in patients with type 2 diabetes improved an establisheded alp resulting in a more favourable lipid and ldl subfraction profile. the long-term clinical implications of these changes await the results of the major intervention trials of lipid modification in type 2 diabetes.