抄録
The effects of one month clofibrate administration on glucose tolerance, plasma immunoreactive insulin (IRI), total cholesterol, triglyceride and HDL-cholesterol levels were studied in 10 patients with non-insulin dependent diabetes mellitus (NIDDM). All patients were treated with ordered diet and/or exercise before and during the administration of clofibrate, 1, 500mg daily after every meals and the study was started after the establishment of the constant body weight and plasma glucose levels.
At the beginning and at 4 weeks of treatment, 75g glucose tolerance test and the measurement of total cholesterol, triglyceride and HDL-cholesterol were made. Plasma glucose, IRI and HDL-cholesterol were determined by the glucose oxidase method, the radioimmunoassay using single antibody method and the precipitation method using Heparin-Ca++, respectively. All data were analyzed by the paired Student's t-test and were expressed as mean±S. E.
1) Fasting plasma glucose levels were 173.4±11.1mg/dl and 137.5±5.9mg/dl (p<0.01) before and at 4 weeks of clofibrate, respectively. While fasting IRI levels were decreased from 12.9±1.7μU/ml to 10.6±2.0μU/ml, but it was not significant statistically.
2) Plasma glucose values after 75g glucose loading showed significant fall in each point (P<0.01), especially at the latter points. On the other hand, IRI response was decreased, while it was not significant, statistically. However ∑IRI/∑glucose ratio before and at 4 weeks of clofibrate were constant and significant correlation was observed.
3) Total cholesterol and triglyceride levels were decreased, while HDL-cholesterol levels were increased statistically after 4 weeks administration of clofibrate. Atherogenic index (total cholesterol-HDL-cholesterol/HDL-cholesterol) was decreased from the value of 4.13±0.20 to 3.13±0.23 (p<0.01).
These observations suggest that clofibrate would be a useful drug to improve the disturbed glucose metabolism in NIDDM together with the enhancement of the HDL-cholesterol levels which are reported to be decreased in diabetics treated with oral hypoglycemic drugs.
