Fenofibrate decreased microalbuminuria in the type 2 diabetes patients with hypertriglyceridemia

Xiaomeng Sun,Jia Liu,Guang Wang

doi:10.1186/s12944-020-01254-2

Abstract

BackgroundThis study was to research the efficacy of fenofibrate in the treatment of microalbuminuria in the patients with type 2 diabetes mellitus (T2DM) and hypertriglyceridemia.MethodsType 2 diabetic patients (56) with microalbuminuria and hypertriglyceridemia aged 30 to 75 were randomly divided into the fenofibrate treatment group(n = 28) and the control group (n = 28) for 180 days. Urinary microalbumin /creatinine ratio (UACR) and other metabolic parameters were compared at baseline, during treatment and after treatment.ResultsAfter 180 days, the reduction of level of fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c) between two groups showed no difference. In the treatment group, uric acid (UA) (296.42 ± 56.41 vs 372.46 ± 72.78), triglyceride (TG) [1.51(1.17, 2.06) vs 3.04(2.21, 3.29)], and UACR [36.45 (15.78,102.41) vs 129.00 (53.00, 226.25)] were significantly decreased compared with the baseline. The high-density lipoprotein cholesterol (HDL-C) levels were significantly increased (1.22 ± 0.26 vs 1.09 ± 0.24) compared with the baseline. The decrease in UACR [− 44.05(− 179.47, − 12.16) vs − 8.15(− 59.69, 41.94)]in treatment group was significantly higher compared with the control group. The decrease in UACR was positively associated with the decreases in TG (r = 0.447, P = 0.042) and UA (r = 0.478, P = 0.024) after fenofibrate treatment.ConclusionIn the patients with hypertriglyceridemia and type 2 diabetes mellitus, fenofibrate can improve microalbuminuria and do not increase the deterioration of glomerular filtration rate.Trial registrationClinicalTrials.gov identifier: NCT02314533, 2014.12.9

Highlights

This study was to research the efficacy of fenofibrate in the treatment of microalbuminuria in the patients with type 2 diabetes mellitus (T2DM) and hypertriglyceridemia
The Action to Control Cardiovascular Risk in Diabetes (ACCORD) study suggested that a lower incidence of both microalbuminuria and macroalbuminuria was noted in the fenofibrate group [7]
No differences were found in age, sex, Body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), Glycosylated hemoglobin (HbA1c), Total cholesterol (TC), TG, high-density lipoprotein cholesterol (HDL-C), Low-density lipoprotein cholesterol (LDL-C), uric acid (UA), Serum creatinine (Scr), FINS, Homeostasis model assessment index of insulin resistance (HOMA-IR), HOMA-β, estimated glomerular filtration rate (eGFR), urinary microalbumin/ creatinine ratio (UACR), or the use of antihypertensive drugs, cholesterol-lowering drugs, and hypoglycemic drugs in two groups (Table 1)

Summary

Introduction

This study was to research the efficacy of fenofibrate in the treatment of microalbuminuria in the patients with type 2 diabetes mellitus (T2DM) and hypertriglyceridemia. The Action to Control Cardiovascular Risk in Diabetes (ACCORD) study suggested that a lower incidence of both microalbuminuria and macroalbuminuria was noted in the fenofibrate group [7]. All these studies are long-term studies with observation periods of 3–5 years. It is unclear whether fenofibrate could impact microalbuminuria on the early stage of the treatment. We designed this study to evaluate fenofibrate’s effect on microalbuminuria change and estimated glomerular filtration rate (eGFR) in Chinese type 2 diabetes patients with hypertriglyceridemia

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Results

Discussion

Conclusion