Clinical studySevere hypertriglyceridemia with insulin resistance is associated with systemic inflammation: reversal with bezafibrate therapy in a randomized controlled trial☆
Section snippets
Methods
The study sample consisted of 18 unrelated patients with endogenous severe hypertriglyceridemia who were recruited from the lipid clinic of the Leiden University Medical Center, The Netherlands. All patients received personal dietary advice. The diagnosis was based on the mean of two fasting blood samples obtained after a prudent diet of at least 8 weeks. Diagnostic criteria for endogenous hypertriglyceridemia (15) were total serum triglyceride level >354 mg/dL (4.0 mmol/L), very low-density
Results
There were no differences between hypertriglyceridemic patients and controls in age, sex, and smoking status, but body mass index was significantly higher in patients with hypertriglyceridemia. Significant differences between both groups were observed for insulin and glucose levels, and insulin resistance. Apolipoprotein B levels did not differ between hypertriglyceridemic patients and controls. Total cholesterol, total triglyceride, and VLDL cholesterol levels were significantly higher,
Discussion
We found that endogenous severe hypertriglyceridemia is associated with an inflammatory state, as represented by higher ex vivo production capacity of TNF-α and IL-6 and elevated levels of C-reactive protein and fibrinogen. Six-week treatment with bezafibrate reduced these markers of inflammation significantly in patients with severe hypertriglyceridemia. The observed increase in IL-6 production and the elevated C-reactive protein levels in patients with severe hypertriglyceridemia without
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2017, Molecular MetabolismCitation Excerpt :Tenenbaum et al. also reported that BEZ treatment was indeed efficient to prevent the increase of HOMA-IR index during two year follow up in patients with coronary artery disease [21]. Although fenofibrate did not change HOMA-IR in patients with impaired glucose tolerance or diabetes, BEZ did significantly decrease HOMA-IR compared to placebo group after 8 weeks of treatment [22] as other studies also reported lower HOMA-IR in BEZ-treated patients [19,23]. In our euglycemic-hyperinsulinemic clamp experiments, insulin stimulus of BEZ-treated animals caused negative endogenous glucose production (EGP) values.
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2016, Clinical BiochemistryCitation Excerpt :The prevalence of hypertriglyceridemia in adults in the USA is approximately 32.6% [4]; the prevalence of hypertriglyceridemia in Iran is reported to be of a similar magnitude (29.0–49.3%) [5]. Previous studies have shown that hypertriglyceridemia is associated with systemic inflammation and atherogenic factors [6,7]. Inflammatory processes are involved at various stages during the atherosclerotic process, from lesion initiation to plaque rupture [8].
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Supported by the Praeventiefonds (#28-1642-4), The Hague, The Netherlands, and by an unrestricted research grant from Boehringer Mannheim, Mannheim, Germany.