Research Article

Pravastatin compared to bezafibrate in the treatment of dyslipidemia in insulin-treated patients with Type 2 diabetes mellitus

  1. C. Rustemeijer1,*,
  2. J. A. Schouten2,
  3. H. J. Voerman1,
  4. H. E. S. J. Hensgens3,
  5. A. J. M. Donker2,
  6. R. J. Heine2

Article first published online: 6 APR 2000

DOI: 10.1002/(SICI)1520-7560(200003/04)16:2<82::AID-DMRR89>3.0.CO;2-G

Issue

Diabetes/Metabolism Research and Reviews

Diabetes/Metabolism Research and Reviews

Volume 16, Issue 2, pages 82–87, March/April 2000

Additional Information

How to Cite

Rustemeijer, C., Schouten, J. A., Voerman, H. J., Hensgens, H. E. S. J., Donker, A. J. M. and Heine, R. J. (2000), Pravastatin compared to bezafibrate in the treatment of dyslipidemia in insulin-treated patients with Type 2 diabetes mellitus. Diabetes/Metabolism Research and Reviews, 16: 82–87. doi: 10.1002/(SICI)1520-7560(200003/04)16:2<82::AID-DMRR89>3.0.CO;2-G

Author Information

  1. 1

    Department of internal medicine Ziekenhuis Amstelveen, Amstelveen, The Netherlands

  2. 2

    Department of internal medicine Free University Hospital, Amsterdam, The Netherlands

  3. 3

    Department of biochemistry Ziekenhuis Amstelveen, Amstelveen, The Netherlands

*Ziekenhuis Amstelveen, P.O. Box 328, 1180 AH Amstelveen, The Netherlands.

Publication History

  1. Issue published online: 6 APR 2000
  2. Article first published online: 6 APR 2000
  3. Manuscript Accepted: 14 DEC 1999
  4. Manuscript Revised: 7 DEC 1999
  5. Manuscript Received: 1 JUL 1999

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Keywords:

  • pravastatin;
  • bezafibrate;
  • Type 2 diabetes mellitus (DM);
  • lipids;
  • lipoprotein composition

Abstract

Background

Both HMG-CoA reductase inhibitors and fibric acid derivates are used for the treatment of dyslipidemia in Type 2 diabetes patients. The aim of this study was to compare the lipid lowering effect of 40 mg pravastatin, a HMG-CoA reductase inhibitor, and 400 mg bezafibrate, a fibric acid derivate, on serum lipids, lipoproteins and lipoprotein composition in 45 (22 men and 23 women) dyslipidemic, insulin-treated Type 2 diabetes patients.

Method

The study used a double-blind, cross-over design.

Results

Pravastatin treatment was more effective in reducing total cholesterol, LDL-cholesterol, LDL-triglycerides, LDL-ApoB and LDL/HDL-cholesterol ratio (all p<0.001 between groups) and total/HDL-cholesterol and ApoA1/LDL-ApoB ratios (both p<0.01) and always induced a decrease in LDL-cholesterol concentrations and LDL/HDL-cholesterol ratio irrespective of baseline triglyceride concentration. Bezafibrate was more effective in increasing HDL-cholesterol (p<0.01 between groups), ApoA1 lipoprotein and decreasing triglycerides (both p<0.001 between groups) but induced an increase in LDL-cholesterol concentration particularly in patients with baseline triglyceride concentrations exceeding 2.0 mmol/l. With bezafibrate treatment the LDL-cholesterol/LDL-ApoB ratio showed a tendency to rise, suggesting a change in the LDL particle composition to a less small and dense form, while pravastatin treatment induced a decrease in this ratio suggesting a change in the LDL particle to a more dense form. With pravastatin treatment a small rise in HbA1c was observed.

Conclusion

Pravastatin treatment is superior in lowering cholesterol-enriched lipoprotein subpopulations and improving cardiovascular risk factors. Bezafibrate is more effective in raising HDL-cholesterol and alters LDL particle composition to a more favorable form. Copyright © 2000 John Wiley & Sons, Ltd.

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