CAN REDUCTION IN HYPERTRIGLYCERIDEMIA SLOW PROGRESSION OF MICROALBUMINURIA IN PATIENTS WITH NON-INSULIN-DEPENDENT DIABETES-MELLITUS

The objective of this study was to investigate whether reduction in hy pertriglyceridaemia is associated with a slower rate of progression of microalbuminuria in patients with non-insulin-dependent diabetes mell itus (NIDDM). Fifteen normotensive NIDDM patients with hypertriglyceri daemia (> 2.5 mmol L-1) and micro-albuminuria were randomly selected t o receive either placebo (eight patients) or gemfibrozil 600 mg b.i.d. (seven patients). Progression of microalbuminuria was assessed during a 12-month follow-up period with measurements, consisting of blood te sts and triplicate 24-h urine collections, at 1, 3, 6, 9 and 12 months . All but one patient in the treatment group showed a favourable respo nse (greater than or equal to 20% reduction) of hypertriglyceridaemia to gemfibrozil. One patient in the placebo group showed a spontaneous reduction in triglyceride levels. Progression of microalbuminuria was lower, although not statistically significantly so, in the treatment g roup (36%) than in the placebo group (65%). In the group with greater than or equal to 20% reduction in triglyceride levels, progression of MA was significantly lower than in the group with stable or increasing triglyceride levels (+1%, range -56% to +49% vs. +97%, range -35% to +202% respectively) (P = 0.03). Continued follow-up data of patients s witching from placebo to gemfibrozil after the trial further support t he role of serum triglyceride reduction in stabilizing albumin excreti on. In conclusion, the results indicate that, in microalbuminuric NIDD M patients, effective treatment of dyslipidaemia could be associated w ith stabilization of urinary albumin excretion.