Bezafibrate improves insulin resistance evaluated using the glucose clamp technique in patients with type 2 diabetes mellitus: a small-scale clinical study

Diabetology & Metabolic Syndrome

Kazuhiro Yamamoto²  Shin-ichi Taniguchi³  Masahiko Kato²  Etsuko Ueta¹  Kazuoki Inoue³  Hiroko Ohkura³  Schoichiro Izawa²  Kazuhiko Matsuzawa³  Risa Nakanishi²  Naoya Yamamoto²  Keisuke Sumi²  Yohei Fujioka²  Tsuyoshi Ohkura²  Hideki Shiochi² 

[1] School of Health Science, Tottori University Faculty of Medicine, Yonago, Tottori 683-8504, Japan;Division of Cardiovascular Medicine, Endocrinology and Metabolism, Department of Molecular Medicine and Therapeutics, Tottori University Faculty of Medicine, Nishi-chou 36-1, Yonago, Tottori 683-8504, Japan;Department of Regional Medicine, Tottori University Faculty of Medicine, Yonago, Tottori 683-8504, Japan

关键词: Insulin resistance;    Japanese patients;    Meal tolerance test;    Glucose clamp;    Type 2 diabetes mellitus;    Bezafibrate;   

Others  :  1114932
DOI  :  10.1186/1758-5996-6-113

 received in 2014-07-18, accepted in 2014-10-09,  发布年份 2014

【 摘 要 】

Background

Bezafibrate is mainly used to treat hypertriglyceridemia. Studies have reported that bezafibrate also improves type 2 diabetes mellitus, but the mechanism has not been fully elucidated. We performed euglycemic hyperinsulinemic clamps (glucose clamp) and meal tolerance tests (MTT) to examine the effects of bezafibrate on insulin resistance in patients with type 2 diabetes mellitus.

Methods

Twelve Japanese patients with type 2 diabetes mellitus and dyslipidemia (mean age: 59.5 years; fasting plasma glucose: 7.95 mmol/L; hemoglobin A1c [HbA1c]: 7.3%; body mass index: 26.5 kg/m²) underwent a glucose clamp and MTT before and after 12 weeks of treatment with 400 mg/day bezafibrate. The glucose infusion rate was measured during the glucose clamp. The patients took a test meal (460 kcal) in the MTT. Plasma glucose and immunoreactive insulin levels were measured at 0 (fasting), 30, 60, 120, and 180 min. Serum C-peptide immunoreactivity, serum lipids, and liver function markers were also measured during the MTT.

Results

Bezafibrate significantly increased the mean glucose infusion rate from 5.78 ± 1.94 to 6.78 ± 2.52 mg/kg/min (p < 0.05). HbA1c improved from 7.30 ± 0.55% to 7.02 ± 0.52% (p < 0.05). In the MTT, fasting plasma glucose decreased from 7.95 ± 1.15 to 6.98 ± 1.07 mmol/L (p < 0.05). The area under the plasma glucose curve from 0 to 180 min decreased significantly from 29.48 ± 5.07 to 27.12 ± 3.98 mmol/h/L (p < 0.05), whereas immunoreactive insulin was unchanged. Furthermore, bezafibrate also significantly improved serum lipids, with decreases in triglyceride levels from 1.84 ± 0.88 to 1.14 ± 0.41 mmol/L (p < 0.05), low-density lipoprotein cholesterol levels from 3.56 ± 0.83 to 2.92 ± 0.55 mmol/L (p < 0.05), and remnant-like particle cholesterol levels decreased from 0.25 ± 0.16 to 0.14 ± 0.06 mmol/L (p < 0.05), and increases in high-density lipoprotein cholesterol levels from 1.50 ± 0.24 to 1.66 ± 0.29 mmol/L (p < 0.05).

Conclusions

Bezafibrate improved glucose intolerance and peripheral insulin resistance in these Japanese patients with type 2 diabetes mellitus and dyslipidemia. Therefore, bezafibrate could be used to treat insulin resistance in patients with type 2 diabetes mellitus and dyslipidemia.

Trial registration

University Hospital Medical Information Network (UMIN) Clinical Trials Registry, UMIN000012462.

【 授权许可】

   
2014 Shiochi et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

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