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Comparison of three treatment approaches to decreasing cardiovascular disease risk in nondiabetic insulin-resistant dyslipidemic subjects.

Abstract
The efficacy of fenofibrate (FEN), rosiglitazone (RSG), or a calorie-restricted diet (CRD) to reduce cardiovascular disease risk was compared in 37 overweight/obese insulin-resistant nondiabetic subjects. Insulin sensitivity, fasting lipids and lipoproteins, and postprandial plasma glucose, insulin, free fatty acid, and triglycerides were measured before and after 3 months of treatment with FEN, RSG, or CRD. Weight decreased in the CRD group, but did not change significantly after treatment with either drug. Insulin sensitivity improved significantly in the CRD- and RSG-treated groups, but to a greater extent in those administered RSG, without a significant difference comparing FEN treatment with the CRD. Total cholesterol was significantly lower after FEN and CRD treatment. Fasting plasma triglycerides decreased significantly in the FEN- and CRD-treated groups, but postprandial concentrations decreased in only FEN-treated subjects. Significant decreases in postprandial glucose and insulin were seen in only the RSG- and CRD-treated groups. FEN administration improved dyslipidemia in these subjects without changing insulin sensitivity, whereas insulin sensitivity was enhanced in RSG-treated patients without improvement in dyslipidemia. Weight loss in the CRD group led to improvements in both insulin sensitivity and dyslipidemia, but the change in the former was less than in RSG-treated patients, and improvement in lipid metabolism not as great as with FEN. In conclusion, there did not appear to be 1 therapeutic intervention that effectively treated all metabolic abnormalities present in these patients at greatly increased risk of cardiovascular disease.
AuthorsFahim Abbasi, Yii-Der Ida Chen, Helke M F Farin, Cindy Lamendola, Gerald M Reaven
JournalThe American journal of cardiology (Am J Cardiol) Vol. 102 Issue 1 Pg. 64-9 (Jul 01 2008) ISSN: 0002-9149 [Print] United States
PMID18572037 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
Chemical References
  • Blood Glucose
  • Fatty Acids, Nonesterified
  • Hypoglycemic Agents
  • Hypolipidemic Agents
  • Lipoproteins
  • Thiazolidinediones
  • Triglycerides
  • Rosiglitazone
  • Cholesterol
  • Fenofibrate
Topics
  • Adult
  • Aged
  • Blood Glucose (metabolism)
  • Caloric Restriction
  • Cardiovascular Diseases (etiology, prevention & control)
  • Cholesterol (blood)
  • Dyslipidemias (complications, drug therapy, physiopathology)
  • Fatty Acids, Nonesterified (blood)
  • Female
  • Fenofibrate (administration & dosage)
  • Humans
  • Hypoglycemic Agents (administration & dosage)
  • Hypolipidemic Agents (administration & dosage)
  • Insulin Resistance
  • Lipoproteins (blood)
  • Male
  • Middle Aged
  • Risk Factors
  • Rosiglitazone
  • Thiazolidinediones (administration & dosage)
  • Triglycerides (blood)

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