Attenuation of progression of insulin resistance in patients with coronary artery disease by bezafibrate

被引:70
作者
Tenenbaum, A
Fisman, EZ
Boyko, V
Benderly, M
Tanne, D
Haim, M
Matas, Z
Motro, M
Behar, S
机构
[1] Chaim Sheba Med Ctr, Cardiac Rehabil Inst, IL-53621 Tel Hashomer, Israel
[2] Chaim Sheba Med Ctr, Bezafibrate Infarct Prevent Study Coordinating Ct, Neufeld Cardiac Res Inst, IL-53621 Tel Hashomer, Israel
[3] Wolfson Med Ctr, Biochem Lab, Holon, Israel
[4] Tel Aviv Univ, Sackler Fac Med, IL-69978 Tel Aviv, Israel
关键词
D O I
10.1001/archinte.166.7.737
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Development of insulin resistance (IR) may be important in the pathogenesis of both metabolic syndrome and type 2 diabetes mellitus. Few data are available regarding the short-term efficacy of the peroxisome proliferator-activated receptor ligand bezafibrate on IR, and its long-term effect is unknown. The present analysis aimed to investigate the effect of bezafibrate on IR in patients with coronary artery disease enrolled in the Bezafibrate Infarction Prevention Study. Methods: Metabolic and inflammatory parameters were analyzed from stored frozen plasma samples obtained from patients who completed a 2-year, randomized, double-blind, placebo-controlled study. The homeostatic indexes of IR (HOMA-IRs) were calculated according to the homeostasis model of assessment. Results: Both the patients taking bezafibrate (n = 1262) and those taking placebo (n = 1242) displayed similar baseline characteristics. The HOMA-IRs significantly correlated at baseline and during follow-up with glucose (r = 0.35 and 0.31, respectively) and triglycerides (r = 0.16 and 0.19, respectively). In a subgroup of 351 patients with diabetes, HOMA-IR at baseline was 88% higher than in their counterparts with normal glucose levels (P < .001). In the placebo group, during follow-up there was a significant 34.4% rise in HOMA-IR. In contrast, in the bezafibrate group there was only a nonsignificant 6.6% change in HOMA-IR. The intergroup differences in percentage changes of HOMA-IR were in favor of bezafibrate (P < .001). Conclusions: In patients with coronary artery disease enrolled in our study, as represented by the placebo group, HOMA-IR increased over time. During the 2 years of the follow-up, bezafibrate significantly attenuated this process.
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页码:737 / 741
页数:5
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