Can reduction in hypertriglyceridaemia slow progression of microalbuminuria in patients with non-insulin-dependent diabetes mellitus?

• Published in: European journal of clinical investigation 1997-12, Vol.27 (12), p.997-1002
• Main Authors: SMULDERS, Y. M., VAN EEDEN, A. E., STEHOUWER, C. D. A., WEIJERS, R. N. M., SLAATS, E. H., SILBERBUSCH, J.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Albuminuria - etiology; Associated diseases and complications; Biological and medical sciences; Diabetes Mellitus, Type 2 - complications; Diabetes. Impaired glucose tolerance; Diabetic Nephropathies - etiology; Diabetic nephropathy; Disease Progression; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Follow-Up Studies; Gemfibrozil - therapeutic use; Humans; hyperlipidaemia; hypertriglyceridaemia; Hypertriglyceridemia - complications; Hypertriglyceridemia - drug therapy; Male; Medical sciences; microalbuminuria; Middle Aged; non-insulin-dependent diabetes mellitus; Random Allocation
• ISSN: 0014-2972; 1365-2362
• DOI: 10.1046/j.1365-2362.1997.2330779.x

The objective of this study was to investigate whether reduction in hypertriglyceridaemia is associated with a slower rate of progression of microalbuminuria in patients with non‐insulin‐dependent diabetes mellitus (NIDDM). Fifteen normotensive NIDDM patients with hypertriglyceridaemia (> 2.5 mmol L−1) and microalbuminuria were randomly selected to 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 tests 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 response (≥ 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 group (36%) than in the placebo group (65%). In the group with ≥ 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 switching from placebo to gemfibrozil after the trial further support the role of serum triglyceride reduction in stabilizing albumin excretion. In conclusion, the results indicate that, in microalbuminuric NIDDM patients, effective treatment of dyslipidaemia could be associated with stabilization of urinary albumin excretion.