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Effect of thiazolidinediones on high-density lipoprotein subfractions
Fernando Ovalle1, David S H Bell
1Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA.
Objective:
To evaluate the effects of thiazolidinediones (TZDs) on specific high-density lipoprotein (HDL) subfractions (HDL2 and HDL3) in patients with type 2 diabetes.
Methods:
We conducted a case-control study in a university diabetes clinic. The study included 45 patients with type 2 diabetes mellitus and dyslipidemia; 31 of these patients received a TZD (troglitazone), and 14 patients received metformin. At the time of the study, the mean duration of therapy was 7 and 11 months, respectively.
Results:
In the TZD group, a significant increase of 12.6% occurred in the total HDL levels (from 34.9 +/- 2.2 mg/dL to 39.3 +/- 2.2 mg/dL; P = 0.0008), whereas no significant change was noted in the metformin group (from 40.9 +/- 3.5 mg/dL to 40.1 +/- 3.2 mg/dL; P = 0.14). All the increase in total HDL levels in the TZD group was due to an increase in the HDL3 subfraction, which rose by 16.7% (from 26.9 +/- 0.9 mg/dL to 31.4 +/- 1.2 mg/dL; P = 0.008). The HDL2 subfraction remained essentially unchanged (from 8.1 +/- 1.7 mg/dL to 7.9 +/- 1.4 mg/dL; P = 0.80). In the metformin group, no significant changes were found in either the HDL3 or the HDL2 subfractions.
Conclusion:
The TZD-induced increase in total HDL levels in our patients was entirely attributable to an increase in the HDL3 subfraction.