Post-prandial metabolism of triglyceride-rich lipoproteins in non-insulin-dependent diabetic patients before and after bezafibrate treatment

• Published in: European journal of clinical investigation Vol. 27; no. 1; pp. 55 - 63
• Main Authors: ATTIA, N., DURLACH, V., ROCHE, D., PAUL, J.-L., SONI, T., ZAHOUANI, A., LANDRON, F., LABROUSSE, F., LEUTENEGGER, M., GIRARD-GLOBA, A.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.01.1997; Blackwell
• Subjects: Aged; Apo CIII; Apolipoprotein C-III; Apolipoproteins C - blood; Apolipoproteins C - drug effects; Apolipoproteins C - metabolism; Bezafibrate - therapeutic use; Biological and medical sciences; Blood Glucose - metabolism; chylomicron; chylomicron remnants; Chylomicrons - blood; Chylomicrons - metabolism; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - metabolism; Dietary Fats - blood; Dietary Fats - metabolism; Fatty Acids, Nonesterified - blood; General and cellular metabolism. Vitamins; Humans; Lipoproteins - blood; Lipoproteins - metabolism; Male; Medical sciences; Middle Aged; non-esterified fatty acids; oral fat load; Pharmacology. Drug treatments; Postprandial Period - drug effects; Postprandial Period - physiology; retinyl palmitate; Triglycerides - blood; Triglycerides - metabolism; Vitamin A - administration & dosage; Vitamin A - analogs & derivatives; Vitamin A - blood; Vitamin A - metabolism; Endocrinopathy; Human; Biochemical analysis; Fibrate derivatives; Postprandial; Metabolic diseases; Lipids; Hyperlipoproteinemia; Lipoprotein; Apolipoproteins; Metabolism; Triglyceride; Fatty acids; Non insulin dependent diabetes; Blood plasma; Chemotherapy; Chylomicron; Treatment; Bezafibrate; Hypertriglyceridemia; Dyslipemia; Antilipemic agent
• ISSN: 0014-2972; 1365-2362
• DOI: 10.1046/j.1365-2362.1997.790630.x

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 (ε3/3, ε3/2 and ε2/2 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.