The effect of Bezafibrate on early-stage diabetic nephropathy was examined. Twenty-four normotensive non-insulin-dependent diabetes mellitus (NIDDM) patients with persistent microalbuminuria, nineteen of them revealed either hypertriglyceridemia or hypercholesterolemia, were treated with Bezafibrate 400mg/day for six months. Urinary albumin/creatinine ratio (ACR) decreased significantly (P<0.05) from the basal value (73.1±12.2mg/g·Cr; mean±SE) to levels of 79.9±9.3% (1M), 74.8±11.8% (2M) and 64.6±10.5% (6M) during Bezafibrate treatment. In eighteen patients, ACR dropped 25% or more from the basal value. Although a significantly lower serum triglyceride levels, fasting plasma glucose levels and diastolic blood pressure were also observed, a significant association was found only between a reduction of ACR and alterations in serum triglyceride levels; not for the other clinical data.
These results suggest that treatment with Bezafibrate reduces microalbuminuria in diabetic patients by a mechanism probably linked to changes in lipid metabolism, and could alleviate incipient diabetic nephropathy. Further studies will be needed to assess the anti-proteinuric effect of Bezafibrate.
