Korean Diabetes Journal 2000;24(6):678-688.
Published online January 1, 2001.
The Effect of Micronized Fenofibrate on the Plasma Levels of Glycated LDL-C, Lp(a) and Insulin Resistance in Patients with Type 2 Diabetes Mellitus.
Mi Kyoung Park, Duk Kyu Kim
Department of Internal Medicine, Dong-A University Medical College, Busan, Korea.
It has been indicated that micronized fenofibrate therapy changes the atherogenic lipid profile into more favorable lipid profile in patients with type 2 diabetes and dyslipidemia. The aim of this study is to evaluate the effect of micronized fenofibrate on the plasma levels of glycated LDL-C, Lp(a), FFA and insulin resistance in patients with type 2 diabetes and dyslipidemia. METHODS: Forty-seven patients with type 2 diabetes (M/F=23/24, mean age 57 +/- 7 yrs) were studied who had relatively good glycemic index (HbA1c < 8.0%) but dyslipidemia (i.e., dyslipidemia : TG >2.25 mmol/L or HDL-C < 0.90 mmol/L or LDL-C >3.36 mmol/L). All the patients were maintained by the previous method of glucose control without change during entire period of the study. The patients were randomized to drug group (Lipidil ) or placebo group for 12 weeks and measured for fasting plasma levels of lipid, glycated LDL-C, Lp(a), insulin, C-peptide, glucose. The results were compared before and after the administration. RESULTS: Micronized fenofibrate therapy significantly reduced the plasma levels of triglyceride, total cholesterol, LDL-C, TC/HDL-C (p<0.0001), FFA (p<0.05) and ele vated the level of HDL-C (p<0.0001) after 12 weeks administration. However, no significant(-3.6%) changes were observed in the level of Lp(a) . In both groups, the plasma levels of glycated LDL-C were elevated even though the glycemic controls were good (drug group: 0.09+/-0.05 mmol/L, placebo group: 0.10+/-0.03 mmol/L), but no significant changes were noticed after administration for 12 weeks (-13.5%, +4.8%, respectively). HOMA-IR index was significantly decreased in the drug group after administration (p<0.01). The change of plasma insulin level was significantly different when compared to that of the placebo group (p<0.05). The plasma level of C-peptide and glycemic indexes (FBS and HbA1c) were not changed significant. CONCLUSION: Micronized fenofibrate therapy for 12 weeks was very effective for control of diabetic dyslipidemia. It significantly reduced FFA to improve the insulin resistance, but it didn't improve the elevated plasma level of glycated LDL-C and Lp(a).
Key Words: Micronized fenofibrate, Glycated LDL-C, Lp(a), Insulin resistance, Type 2 diabetes mellitus, Dyslipidemia

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