Effects of fibric acid derivatives and metformin on postprandial lipemia

It was suggested that postprandial lipoproteins (PPLp) may play an importan t role in atherogenesis. We studied PPLp metabolism and its response to dru gs in seven hypertriglyceridemic subjects, 23 men with isolated low HDL-C l evels, and nine non-diabetic glucose intolerant subjects. Results were comp ared with those found in a group of 19 healthy normolipidemic individuals. We used the vitamin A-fat loading test which specifically labels PPLp with retinyl palmitate (RP). In the hypertriglyceridemics the areas under RP cur ves of the chylomicrons were 6.3-fold and those of non-chylomicrons 2.9-fol d higher than in normals (P < 0.01). Gemfibrozil 1200 mg/day caused a drama tic decrease in chylomicrons 73% and nonchylomicrons 31%. In subjects with isolated low HDL-C, RP chylomicron curves were significantly higher than in normals (17.733 +/- 6.821 vs 13939 +/- 6217 mu g/l per h, P < 0.005). Beza fibrate 400 mg/day reduced RP chylomicrons and nonchylomicron levels by 35% (P < 0.0001) in 15 responders with an increase in fasting HDL-C 35 +/- 3 t o 40 +/- 22 mg/dl (P < 0.0001). No response was found in eight subjects. In the nine glucose intolerant subjects, metformin reduced postprandial insul in area under the curve from 389 to 245 mU/ml (P < 0.01) chylomicron and no nchylomicron RP areas were 3.6- and 3-fold higher than in normals and were reduced by 56 and 32%, respectively. In conclusion gemfibrozil, bezafibrate and metformin were shown to be beneficial in the clearance of PPLp in hype rtriglyceridemic patients, subjects with isolated low HDL-C levels and nond iabetic glucose intolerant subjects, respectively. (C) 1998 Elsevier Scienc e Ireland Ltd. All rights reserved.