Influence of etofibrate on LDL-subtype distribution in patients with diabetic dyslipoproteinemia.

Abstract

Low density lipoprotein (LDL-) particles can be subfractionated in large-buoyant (lb), intermediate-dense (id) and small-dense (sd) LDL-subtypes. Fibrates improve the LDL-subtype profile by reducing proatherogenic sd-LDL which are prominent in diabetic dyslipoproteinemia. We evaluated the effect of etofibrate on the LDL-subtype distribution in patients with type 2 diabetes mellitus (n = 13, 55 +/- 18 years, BMI 27.9 +/- 5.5 kg/m2, HbA1c 10.1 +/- 3.9 %) and diabetic dyslipoproteinemia (triglycerides 343 +/- 253 mg/dl, HDL-cholesterol 36 +/- 7 mg/dl, LDL-cholesterol 110 +/- 37 mg/dl). Plasma lipids (enzymatic methods) and LDL-subtypes (7 LDL-subfractions, density gradient ultracentrifugation) were measured before and during etofibrate therapy (500 mg/d, 7 - 16 weeks). Etofibrate significantly (p < 0.05, Wilcoxon-test) reduced triglycerides (- 31 +/- 60 %) and increased HDL-cholesterol (+ 24 +/- 22 %), whereas total cholesterol and LDL-cholesterol did not change. Cholesterol concentration decreased in sd-LDL by 12 % (p < 0.05), while it increased in id- and lb-LDL (+ 26 %,+ 39 %, respectively). Thus, the LDL-subtype profile showed a relative increase of the fraction of lb- (+ 13 +/- 32 %, n.s.) and id-LDL (+ 23 +/- 33 %, p < 0.05) and a relative decrease of the fraction of sd-LDL (- 19 +/- 18 %, p < 0.05). We conclude that etofibrate not only decreases triglycerides and increases HDL-cholesterol but also improves the LDL-subtype profile and thus may reduce the cardiovascular risk in patients with an abundance of sd-LDL such as diabetic patients.

• Authors: H C Geiss, M Dietlein, K G Parhofer
• Journal: Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association (Exp Clin Endocrinol Diabetes) Vol. 111 Issue 6 Pg. 322-4 (Sep 2003) ISSN: 0947-7349 [Print] Germany
• PMID: 14520596 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Cholesterol, HDL
• Glycated Hemoglobin A
• Hypoglycemic Agents
• Hypolipidemic Agents
• Lipoproteins, LDL
• Triglycerides
• etofibrate
• Clofibric Acid
• Cholesterol

Topics

• Adult
• Aged
• Body Mass Index
• Cholesterol (blood)
• Cholesterol, HDL (blood)
• Clofibric Acid (analogs & derivatives, therapeutic use)
• Diabetes Complications
• Diabetes Mellitus (blood, drug therapy)
• Diabetes Mellitus, Type 2 (drug therapy)
• Female
• Glycated Hemoglobin (metabolism)
• Humans
• Hyperlipidemias (blood, drug therapy)
• Hypoglycemic Agents (therapeutic use)
• Hypolipidemic Agents (therapeutic use)
• Lipoproteins, LDL (blood, classification, drug effects)
• Male
• Middle Aged
• Triglycerides (blood)