Exp Clin Endocrinol Diabetes 2003; 111(6): 322-324
DOI: 10.1055/s-2003-42720
Article

J. A. Barth Verlag in Georg Thieme Verlag Stuttgart · New York

Influence of Etofibrate on LDL-Subtype Distribution in Patients with Diabetic Dyslipoproteinemia

H. C. Geiss 1 , M. Dietlein 2 , K. G. Parhofer 1
  • 1Department of Internal Medicine II, Grosshadern, University of Munich, Munich, Germany
  • 2Diabeteszentrum, Krankenhaus Haunstetten, Augsburg, Germany
Further Information

Publication History

Received: July 17, 2002 First decision: October 18, 2002

Accepted: January 10, 2003

Publication Date:
01 October 2003 (online)

Abstract

Low density lipoprotein (LDL-) particles can be subfractionated in large-buoyant (lb), intermediate-dense (id) and small-dense (sd) LDL-subtypes. Fibrates improve the LDL-subtype profile by reducing proatherogenic sd-LDL which are prominent in diabetic dyslipoproteinemia. We evaluated the effect of etofibrate on the LDL-subtype distribution in patients with type 2 diabetes mellitus (n = 13, 55 ± 18 years, BMI 27.9 ± 5.5 kg/m², HbA1c 10.1 ± 3.9 %) and diabetic dyslipoproteinemia (triglycerides 343 ± 253 mg/dl, HDL-cholesterol 36 ± 7 mg/dl, LDL-cholesterol 110 ± 37 mg/dl).

Plasma lipids (enzymatic methods) and LDL-subtypes (7 LDL-subfractions, density gradient ultracentrifugation) were measured before and during etofibrate therapy (500 mg/d, 7 - 16 weeks). Etofibrate significantly (p < 0.05, Wilcoxon-test) reduced triglycerides (- 31 ± 60 %) and increased HDL-cholesterol (+ 24 ± 22 %), whereas total cholesterol and LDL-cholesterol did not change. Cholesterol concentration decreased in sd-LDL by 12 % (p < 0.05), while it increased in id- and lb-LDL (+ 26 %,+ 39 %, respectively). Thus, the LDL-subtype profile showed a relative increase of the fraction of lb- (+ 13 ± 32 %, n.s.) and id-LDL (+ 23 ± 33 %, p < 0.05) and a relative decrease of the fraction of sd-LDL (- 19 ± 18 %, p < 0.05).

We conclude that etofibrate not only decreases triglycerides and increases HDL-cholesterol but also improves the LDL-subtype profile and thus may reduce the cardiovascular risk in patients with an abundance of sd-LDL such as diabetic patients.

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M. D. Klaus G. Parhofer

Department of Internal Medicine II, Klinikum Grosshadern

Marchioninistr. 15

81377 Munich

Germany

Phone: + 498970953011

Fax: + 49 89 70 95 88 79

Email: parhofer@med2.med.uni-muenchen.de