POSTPRANDIAL LIPOPROTEIN CLEARANCE IN TYP E-2 DIABETES - FENOFIBRATE EFFECTS

Lipoprotein abnormalities [mainly high levels of very low-density lipo protein triglycerides (TG) and low levels of high-density lipoprotein cholesterol] increase the risk of cardiovascular disease in Type 2 dia betic patients. Moreover, only fasting TG and central obesity appear t o independently predict mortality from CAD in glucose-intolerant and d iabetic subjects. It is noteworthy that fasting lipid levels in these patients are often relatively unaffected, and that plasma TG may remai n 2 g/l, the cutoff point currently considered to define moderate hype rtriglyceridemia. Our study of postprandial lipaemia shows that lipid intolerance (a greater increase of postprandial TG and a slower return towards basal levels) was almost always present in these patients, en abling us to detect atherogenic changes in plasma lipoproteins. Prelim inary results indicate that fenofibrate treatment in Type 2 diabetes u nder optimised metabolic control improves not only fasting lipid level s but also postprandial lipaemia and associated abnormalities in lipop rotein levels and composition.