Effects of bezafibrate on insulin sensitivity and insulin secretion in non-obese Japanese type 2 diabetic patients

The aim of the present study was to investigate the effect of bezafibrate o n insulin sensitivity and insulin secretion in 30 non-obese Japanese type 2 diabetic patients with hypertriglyceridemia (serum triglycerides > 150 mg/ dL). Insulin sensitivity was measured with homeostasis model assessment ins ulin resistance (HOMA-IR) proposed by Matthews et at. HOMA-B-cell function, proposed by Matthews et al validated against minimal model-derived insulin secretion, was used to assess pancreatic insulin function. Twenty-two pati ents were treated with glibenclimide and the rest were treated with diet al one. All patients were treated with bezafibrate (400 mg/d) for 3 months. Th ere were no changes in diet and the dose of any medications used throughout the study. Fasting glucose, insulin, triglycerides, HDL cholesterol, and t otal cholesterol levels were measured before and after treatment of bezafib rate. After treatment of bezafibrate for 3 months, serum triglyceride level s significantly decreased from 277 +/- 30 to 139 +/- 9 mg/dL (P < .001) and serum HDL cholesterol levels increased significantly from 45 <plus/minus> 2 to 52 +/- 2 mg/dL (P = .003). Serum cholesterol level was unchanged durin g the study (198 +/- 7 v 201 +/- 7 mg/dL, P = .383). Fasting glucose (163 /- 8 v 139 +/- 6 mg/dL, P = .006) significantly decreased after the treatme nt with bezafibrate. HbA1c levels decreased, although not statistically sig nificant (7.50 +/- 0.25 v 7.17% +/- 0.19%, P = .147). On the other hand, fa sting insulin (9.3 +/- 0.7 v 7.3 +/- 0.5 muU/mL, P = .010) and HOMA-IR (3.6 1 +/- 0.24 to 2.53 +/- 0.20, P < .001) levels decreased significantly after the treatment with bezafibrate. In contrast, HOMA-B-cell function did not change during the study (41.4 <plus/minus> 5.5 v 41.8 +/- 4.7, P = .478). T here was no significant difference in body mass index (BMI) levels before a nd after the therapy (23.0 +/- 0.4 v 23.1 +/- 0.4 kg/m(2), P = .483). From these results, it can be concluded that bezafibrate reduces serum tiglyceri des, insulin resistance, and fasting blood glucose levels in non-obese Japa nese type 2 diabetic patients. Copyright (C) 2001 by W.B. Saunders Company.