Effect of a Reduced-Fat Diet With or Without Pravastatin on Glucose Tolerance and Insulin Sensitivity in Patients with Primary Hypercholesterolemia
| Autor: | Tiziana Sampietro, Alfredo Quiñones Galvan, Silvia Frascerra, Giuseppe Seghieri, Fabio Galetta, Andrea Natali, Ele Ferrannini, Simona Baldi |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Glucose uptake medicine.medical_treatment Familial hypercholesterolemia Hyperlipoproteinemia Type II chemistry.chemical_compound High-density lipoprotein Internal medicine Hyperlipidemia medicine Humans Insulin Diet Fat-Restricted Triglycerides Pravastatin Pharmacology Glucose tolerance test medicine.diagnostic_test business.industry Cholesterol Anticholesteremic Agents Glucose Tolerance Test Middle Aged medicine.disease Lipoproteins LDL Endocrinology chemistry Female lipids (amino acids peptides and proteins) Lipoproteins HDL Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Journal of Cardiovascular Pharmacology. 28:595-602 |
| ISSN: | 0160-2446 |
| DOI: | 10.1097/00005344-199610000-00019 |
| Popis: | Pharmacological treatment of hyperlipidemia may be associated with deterioration of glucose tolerance. We randomized 20 nonobese patients with primary familial hypercholesterolemia (serum total cholesterol 7.8 +/- 0.4 mM, triglycerides 1.4 +/- 0.2 mM) to an isocaloric, reduced fat (< 30%) low-cholesterol (200 mg/day) diet with placebo or pravastatin (40 mg/day). Oral glucose tolerance, endogenous insulin response to glucose, insulin sensitivity (determined by the euglycemic insulin clamp technique), hepatic glucose production (by the tritiated glucose technique), and substrate utilization (by indirect calorimetry) were measured at baseline and after 8 weeks of treatment. Ten normocholesterolemic healthy subjects, matched to the patients by age, sex, and body weight, served as the control group. Diet alone (with no change in body weight) was associated with a significant 15% decrease in both serum low density lipoprotein (LDL)-cholesterol and triglycerides (p < 0.001 for both), and a slight decrease in high density lipoprotein (HDL)-cholesterol concentrations, paralleled by reductions in Apo B, C2, C3, and E levels (p < 0.05 or less). The addition of pravastatin led to a significantly larger reduction in LDL-cholesterol (30%, p < 0.05) and an 8% increase (p < 0.02) in total HDL-cholesterol concentrations. Accordingly, the ratio of LDL:HDL cholesterol (which was 60% higher than in controls at baseline) remained unchanged in the placebo-diet group whereas it was restored to normal in the pravastatin-diet group. Glucose tolerance, insulin response, insulin-induced inhibition of hepatic glucose production and lipolysis, and insulin-mediated glucose uptake and oxidation were all slightly but not significantly improved after treatment, with no significant differences between pravastatin and placebo. In nonobese patients with primary hypercholesterolemia, pravastatin treatment in combination with an isocaloric, reduced-fat diet leads to a marked reduction in LDL-cholesterol and triglycerides levels and a normalization of the LDL:HDL ratio without affecting glucose tolerance or insulin sensitivity. |
| Databáze: | OpenAIRE |
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