الفهرس 
Diabetes MellitusOnly 14 pages are availabe for public view
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Abstract
The current research was conducted to get the measure of fenofibrate adjuvant therapy influence [peroxisome proliferative activated receptor alpha agonist (PPAR-α)] on endothelial dysfunction biomarkers and atherogenic indices in T2DM patients.
Methods: A randomized, controlled, prospective, parallel study, a total number of 75 male and female subjects with age range of 30-58 years old were divided into three groups: control group (group 1) which involved 25 healthy subjects who were in attendance for their periodic checkup; group 2 which consisted of 25 patients with T2DM received oral glimepiride/
metformin (2:500 mg/day) alone; and group 3 which included 25 patients with T2DM received oral glimepiride/metformin (2:500 mg/day) plus oral fenofibrate adjuvant therapy 300 mg/day. Diabetic patients were enrolled from Tanta University Hospital, Internal Medicine Department, Endocrinology Unit and assessed before and 3-months after intervention for determination of clinical parameters [body mass index (BMI), systolic and diastolic blood pressure], glycemic picture [fasting blood glucose, HbA1C %, HOMA-IR index], lipid panel, atherogenic indices [AI: atherogenic index, Castelli’s risk index (CRI-I), CRI-II], endothelial dysfunction biomarkers [Syndecan-1 (SDC-1), asymmetric dimethylarginine (ADMA), soluble adhesion molecule E-selectin (sE-selectin)] and [ACR: albumin to creatinine ratio]. Data were statistically analyzed by ANOVA test; statistical significant was considered at P< 0.05.
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Results: Addition of fenofibrate adjuvant therapy to oral hypoglycemic drugs (group 3) provoked significant decrease in all measured parameters when compared with group 2 (P< 0.05). As compared to group 1 (control group), group 3 showed no significant difference in most measured parameters 3-months after therapy. For T2DM patients of group 3, endothelial dysfunction biomarkers [SDC-1, sE-selectin, ADMA] showed significant positive correlation with atherogenic indices [AI, CRI-I, CEI-II] and all measured parameters except for HDL-C which exhibited significant negative correlation 3-months after therapy (P< 0.05).
Conclusion: Introduction of fenofibrate to oral hypoglycemic drugs improved vascular endothelial dysfunction, atherogenic indices, glycemic picture, lipid panel, ACR, blood pressure and reduced the body mass index in patients with T2DM. The present study reports that fenofibrate is a felicitous protocol in remediation and prevention of T2DM related vascular complication, also other PPAR-α agonist could be examined.
Keywords: T2DM; Fenofibrate; Endothelial dysfunction; Syndecan-1; ADMA; sE-selectin; Atherogenic index; Castelli’s risk index.