1996 Volume 39 Issue 10 Pages 757-763
The present study was conducted in order to examine the effect of an α-glucosidase inhibitor, acarbose, on plasma lipoproteins, especially on the plasma remnant-like particle (RLP) fraction and low density lipoprotein (LDL) particle size, in 32 patients with non-insulin dependent diabetes mellitus (NIDDM) subjects (16 male, 24 on diet and 8 on sulfonylureas). Patients who were obese, who had thyroid, renal or hepatic diseases, or those taking steroids, diuretics, β-blockers, or hypolipidemic drugs were excluded. After more than one month of stabilized blood glucose control with diet or sulfonylureas, acarbose (100 or 150mg/day) was administered. The dose was increased to 300mg/day in 3 divided doses by the 2nd month. Fasting plasma glucose and hemoglobin Alc levels tended to decrease during the 3 months of the study period but the differences were not significant. There were no significant changes in plasma levels of cholesterol, free fatty acids, apolipoprotein (apo) Al, apo B and apo E after treatment. RLP-triglyceride levels showed a significant decrease at the 3rd month while total triglyceride and RLP-cholesterol showed no significant decrease after treatment. Eighteen patients with small sized LDL (diameter less than 25.5 nm) demonstrated significantly increased LDL size at the 3rd month. Their average plasma triglyceride was significantly suppressed from the 2nd month. Although the precise mechanisms are not known, acarbose exerted favorable effects on NIDDM patients through reducing the population of atherogenic lipoproteins such as remnant-like lipoproteins and small sized LDL.
