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Post‐prandial metabolism of triglyceride‐rich lipoproteins in non‐insulin‐dependent diabetic patients before and after bezafibrate treatment
Author(s) -
ATTIA N.,
DURLACH V.,
ROCHE D.,
PAUL J.L.,
SONI T.,
ZAHOUANI A.,
LANDRON F.,
LABROUSSE F.,
LEUTENEGGER M.,
GIRARDGLOBA A.
Publication year - 1997
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1046/j.1365-2362.1997.790630.x
Subject(s) - medicine , endocrinology , bezafibrate , lipolysis , hypertriglyceridemia , triglyceride , chylomicron , insulin , diabetes mellitus , chemistry , lipoprotein , cholesterol , very low density lipoprotein , adipose tissue
Retarded post‐prandial (pp) lipid clearance is potentially a major component of the increased cardiovascular risk incurred by hypertriglyceridaemic non‐insulin‐dependent diabetic mellitus (NIDDM) patients. The effect of bezafibrate (Bz, 400 mg per day for 5 weeks on chylomicron (CM) and remnant clearance after loads of 100 g of fat and vitamin A was therefore explored in 10 male patients (glycaemia 11.9 ±3.3 TG 4.5 ±2.4 mmol L –1 ). In all subjects CM‐TG and retinyl palmitate (RP) were reduced by 50%, but 8‐h non‐CM (remnant) RP decreased only in initially mildly hypertriglyceridaemic subjects (−35%, P <0.05), while in three patients with very elevated initialTG (ε 3/3 , ε 3/2 and ε 2/2 genotypes) 8‐h remnant RP increased by 100%. The decrease in pp CM‐TG correlated with that of fasting Sf 20–400 ( r = 0.686, P = 0.026), suggesting that improved lipolysis was a major determinant of hypolipidaemic effect. Apo CIII synthesis is known to be depressed by Bz: concentrations were lower under Bz ( P <0.05). A positive correlation ( r =0.880, P <0.001) with fasting TG before treatment and its disappearance after treatment suggested an involvement of high concentrations with hypertriglyceridaemia. Post‐prandial non‐esterified fatty acids were decreased by 35 in correlation with a significant (−19%, P <0.05) improvement in fasting glycaemia ( r =‐.801, P <0.005). These results suggest that Bz acts both on lipolysis and on removal of CM remnants, but that removal can become saturated when lipolysis is massively improved.