Comparison of the efficacy of fenofibrate and acipimox on plasma lipoprotein subclasses distribution in the Chinese population with Type 2 diabetes mellitus and hypertriglyceridemia

Aim: To compare the effects of fenofibrate and acipimox on lipoprotein subclasses distribution in the Chinese population with Type 2 diabetes mellitus (T2DM) and hypertriglyceridemia. Patients & methods: Sixty-six patients were recruited for the 2-month study, and were divided randomly into a micronized fenofibrate group (160 mg/day; n = 33) and an acipimox group (500 mg/day; n = 33), respectively. HDL subclasses were measured by 2D gradient gel electrophoresis coupled with immunoblotting; LDL subclasses were measured by 1D gradient gel electrophoresis. Results: Compared with baseline, both fenofibrate and acipimox increased HDL2b, whereas HDL3a, small, dense LDL and oxidized LDL decreased significantly. Lipoprotein(a) significantly decreased in acipimox but not the fenfibrate group. No difference was found between these two groups on the changes of lipoprotein subclasses. Conclusion: Fenofibrate and acipimox therapy were comparably effective in modifying atherogenic lipids profile, and contributed to metabolism of HDL subclasses maturation in the Chinese population with T2DM and hypertriglyceridemia. Meanwhile, the acipimox intensively decreased lipoprotein(a) levels.