Comparison of the effects of bezafibrate and acipimox on the lipid pattern and plasma fibrinogen in hyperlipidaemic type 2 (non-insulin-dependent) diabetic patients

Abstract

Correction of cardiovascular risk factors is of particular significance in a high-risk population, such as that of diabetic patients. This paper reports the effects of one-month administration of 400 mg/day Bezafibrate (BZF), followed by a two-month wash-out and one-month administration of 500 mg/day Acipimox (APX) or vice versa in a random order in 16 Type 2 diabetic patients with diet-resistant hyperlipidaemia and in good metabolic control (HbA1c less than 8%), on plasma fibrinogen and on their lipid pattern. Metabolic control displayed a nonsignificant improvement (HbA1c) during both treatments (stable body weight). Both BZF and APX produced a 14% decrease in total CHOL (p less than 0.01), whereas BZF was more effective in reducing triglycerides (tg) (-37% vs -15%). The marked BZF-induced Tg reduction was associated with a proportional decrease in Apo B, while an increase in total HDL-, HDL2 and HDL3-CHOL, together with a significant increase in Apo AI, was observed. APX treatment resulted in a HDL2-CHOL increase only (+29%). Both drugs reduced VLDL-CHOL (BZF -37%; APX -15%) and VLDL-Tg (-56% and -34%). In BZF treated patients Apo CIII fell indicating a possible reduction of specific inhibition of lipoprotein lipase activity, while APX affected both Apo CII (+23%) and Apo CIII (-26%) and led to a 62% Apo CII/CIII ratio increase. BZF alone led to a significant 25% decrease in plasma fibrinogen (from 415 +/- 14.3 to 312.1 +/- 18.1 SEM mg/dl, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)