Pravastatin compared to bezafibrate in the treatment of dyslipidemia in insulin-treated patients with Type 2 diabetes mellitus

✍ Scribed by C. Rustemeijer; J. A. Schouten; H. J. Voerman; H. E. S. J. Hensgens; A. J. M. Donker; R. J. Heine

• Publisher: John Wiley and Sons
• Year: 2000
• Tongue: English
• Weight: 99 KB
• Volume: 16
• Category: Article
• ISSN: 1520-7552
• DOI: 10.1002/(sici)1520-7560(200003/04)16:2<82::aid-dmrr89>3.0.co;2-g

✦ Synopsis

Background Both HMG-CoA reductase inhibitors and ®bric acid derivates are used for the treatment of dyslipidemia in Type 2 diabetes patients. The aim of this study was to compare the lipid lowering effect of 40 mg pravastatin, a HMG-CoA reductase inhibitor, and 400 mg beza®brate, a ®bric acid derivate, on serum lipids, lipoproteins and lipoprotein composition in 45 (22 men and 23 women) dyslipidemic, insulin-treated Type 2 diabetes patients.

Method

The study used a double-blind, cross-over design.

Results Pravastatin treatment was more effective in reducing total cholesterol, LDL-cholesterol, LDL-triglycerides, LDL-ApoB and LDL/HDLcholesterol ratio (all p<0.001 between groups) and total/HDL-cholesterol and ApoA1/LDL-ApoB ratios (both p<0.01) and always induced a decrease in LDL-cholesterol concentrations and LDL/HDL-cholesterol ratio irrespective of baseline triglyceride concentration. Beza®brate was more effective in increasing HDL-cholesterol ( p<0.01 between groups), ApoA1 lipoprotein and decreasing triglycerides (both p<0.001 between groups) but induced an increase in LDL-cholesterol concentration particularly in patients with baseline triglyceride concentrations exceeding 2.0 mmol/l. With beza®brate treatment the LDL-cholesterol/LDL-ApoB ratio showed a tendency to rise, suggesting a change in the LDL particle composition to a less small and dense form, while pravastatin treatment induced a decrease in this ratio suggesting a change in the LDL particle to a more dense form. With pravastatin treatment a small rise in HbA 1c was observed.

Conclusion

Pravastatin treatment is superior in lowering cholesterolenriched lipoprotein subpopulations and improving cardiovascular risk factors. Beza®brate is more effective in raising HDL-cholesterol and alters LDL particle composition to a more favorable form.