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Comparison between perindopril and candesartan in hypertensive patients with type 2 diabetes: evaluation of lipid profile and Lp (a)
Posters 2. Diabetes - clinical research
56
(coronary heart disease (CHD), stroke, or ischemic vessel disease of the limbs). The patients were divided into two groups upon postprandial TG elevation: Group I (7 patients) with low postprandial lipaemia (elevation of TG to maximum 1.6 multiple fasting TG concentration). Group II (11 patients) with postprandial hyperlipaemia (elevation of TG more than 1.6 multiple fasting TG concentration). Both groups were significantly different in TG levels at time 4 (1.8f0.71 vs. 2.9f0.88 mmoV1,p < 0.05) and time 6 (2.OjzO.85vs. 2.9~!~0.88mmol/l, p < 0.05) after the test breakfast, in area under curve (AUC) of TG (15.5f6.55 vs. 20.1f5.71, p < 0.05), in renal functions (urea 9.Ozb4.29vs. 4.7h1.32 mmoY1,creatinine 125.3h19.51 vs. 90.8k11.32 mmol/l) and in incidence of arterial hypertension and CHD (71.4% vs. 18.2%). AUC TG was equal to TG concentration at time 0. Both groups were not different in other observed parameters of lipid metabolism, diabetic control and treatment nor in other biochemical parameters. Conclnsions: Our results are partly compatible to published papers, which show a close relation of fasting and postprandial TG levels. Higher incidence of late macrovascular complications, arterial hypertension and renal handicap in group with lower postprandial lipaemia can be falsed by scarcity of tested patients and it should be studied. IP36 COMPARISON
BETWEEN PERINDOPRIL AND CANDESARTAN IN HYPERTENSIVE PATIENTS WITH TYPE 2 DIABETES: EVALUATION OF LIPID PROFILE AND LP (a)
G. Derosa, A. Mugellini, R. Fogari. Department of Internal Medicine and Medical Therapy, IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy mose of the Study: This study evaluated the impact of perindopril (P) and candesartan (C) on Fast PlasmaGlucose (FPG), lipid profile (Total Cholesterol (TC). LDL-Cholesterol (LDL-C), HDL-Cholesterol, Triglycerides) and Lipoprotein (a) (Lp (a)) in hypertensive (Sistolic Blood Pre&rre (SBP) > 130 mmHg and Diastolic Blood Pressure (DBP) > 85 mmHg) patients with type 2 diabetes. Methods: We evaluated 96 hypertensive patients with type 2 diabetes with normal lipid profile, and in good glucose control. We administered perindopril, 4 mg/day or candesartan, 8 mg/day, over a period of 6 months, in randomized, double-blind clinical trial. Summary of Results: We saw a significant variation from basaline to the sixth month during the treatment with P in SBP (147f6 vs 134f5 mmHg, p < O.Ol), DBP (94f4 vs 83f3.2 mmHg, p < O.Ol), FPG (155ltl5 vs 140f15 mg/dl, p < 0.05), TC (180f15 vs 168flO mg/dl, p < 0.05), LDLC (120f18 vs 106z.tlO mg/dl, p < 0.05), and in Lp(a) (29&12 vs 24&6 mg/dl, p < 0.05); during the treatment with C in SBP (148f6 vs 13615 mmHg, p < O.Ol), and in DBP (93f5 vs 85f3.8 mmHg, p < 0.01). When we interrumpted P and C therapy for 1 month, we observed a tendency to come back to the basaline values, and only SBP with both P and C had still significant values (p < 0.05). Conclusions: Perindopril and candesartan are effective to lower blood pression. Perindopril showed an improvement on some metabolic parameters compared to candesartan. This improvement could be due to his action on insulin sensitivity, with an increase of peripheral glucose utilization and reduction of lipid profile and Lp(a), even if it can not be excluded a direct action of perindopril on lipid and Lp (a) metabolism. w
EFFECTS OF FOSINOPRIL ON LIPID PROFILE AND Lp(a) IN NORMOTENSIVE PATIENTS WITH TYPE 2 DIABETES AND MICROALBUMINURIA
G. Derosa, A. Mugellini, R. Fogari. Department of Internal Medicine and Medical Therapy, IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy
mg/dl, p < 0.05), LDL-C (124&10 vs 114fll mg/dl, p < 0.05), Lp(a) (24flO vs 19f7.5 mg/dl, p < 0.05), and in AER (123f31 vs 68 + 21 r&/24 h, p < 0.01). When we interrumpted fosinopril therapy for 1 month, we observed a tendency to come back to the basaline values. Conclusions: Fosinopril treatment gave a reduction of microalbumimnia and it also showed to improve lipid profile and Lp (a) in type 2 diabetics. This suggests that fosinopril, lowering pmteinuria, achieved a improvement in lipid profile and Lp (a). It is possible that this action was not only related to the reduction in protemuria but to some other, more direct action of fosinopril on lipid and Lp (a) metabolism. Ip381 ELEVATED SERUM LIPOPROTEIN(a) LEVELS IN TYPE 1 AND TYPE 2 DIABETIC PATIENTS AMONG MALAYSIAN MALAYS
H.M. Nawawi, M. Muhajir, C.K. Yeo, W.M. Wan Naxaimoon, K. Yusoff, B.A.K. Khalid. Faculty of Medicine, Hospital Universiti Kebangsaan Malaysia (HUKMJ Kuala Lumpur. Malaysia
Lipoprotein (a) [Lp(a)] is a potential risk factor for coronary heart disease (CAD) in patients with diabetes mellitus (DM). Studies on serum Lp(a) in DM have revealed controversial results. The objective of this study was to examine and compare serum Lp(a) concentration of type 1 and type 2 diabetic patients among Malaysian Malays. We studied a total of 26 type 1 (11 males, 15 females, mean + SD age (years) = 31.8f8.0) and 107 type 2 Malay diabetic patients (52 males, 55 females, age = 42.9f10.6), and 126 non-diabetic normocholesterolaemic Malay controls (56 males, 70 females, age = 43.4h8.4). Patients were subdivided into the hypercholesterolaemic [HC] (TC > 5.7 mmol/L) and normocholestemlaemic [NC] (TCc5.7 mmol/L) subgroups. Serum Lp(a) was measured by an immunoturbidimetric method (Roche Diagnostics. Cobas Mira). Fasting lipid profile, glucose, HbAlc and urinary albumin were also determined: There was significantly higher serum Lp(a) concentration in all type 1 diabetic patients compared to controls (p
ERYTHROCYTE SEDIMENTATION RATE (ESR), AN MARKER, MAY BE AN OLD CHEAP INFLAMMATION INDICATOR OF ATHEROSCLEROSIS IN DIABETIC PEOPLE?
0. Giampietro, E. Boldrini, G. Forotti, E. Matteucci, A. Clerico. Purpose
of the Study: This study evaluated Fast Plasma Glucose (FPG),
lipid profile Total Cholesterol (TC), LDL-Cholesterol (LDL-C), HDLCholesterol, Triglycerides) and Lipoprotein (a) (Lp (a)) in normotensive (Sistolic Blood Pressure (SBP) < 130 mmHg and Diastolic Blood Pressure @BP) < 85 mmHg) pauents’with type 2 diabetes and microalbuminuria (AER), during therapy with fosinopril and aider its halt. Methods: We enrolled 120 normotensive patients with type 2 diabetes and microalbuminuria with normal lipid profile, and in good glucose control. We administered fosinopril, 10 mg/day over a period of 6 months. Summary of Results: We noted a significant variation from basaline to the sixth month of this treatment in SBP (125f4.1 vs 119f5 mmHg, p < O.Ol), DBP (80f4.8 vs 74f4.5 mmHg, p < 0.05), TC (186&11 vs 176flO
Dipartimento di Medicina Interna, Universita di Pisa, Italy
Int&umnation seems to play a role in atherosclerosis. Thus, in addition to C-reactive protein (CRP), may be of interest to measure different intlammation proteins in risk individuals. We measured the 1st hour ESR serum fibrinogen (sFB), CRP, C3c and C4 complement fractions, mucoproteins (acidal glycoprotein, alG), total proteins (sTP) and fractions, leucocyte count (WCC) together with serum total (T-Ch) and HDL-cholesterol (HDLCh), triglycerides (TG), homocysteine (tHcy), Lp(a) in 112 type 2 diabetic uatients (61.3f9.7 age vrs; 30.7f6.2 Kg/m2 BMI: 11.4f9.9 vrs diabetes duration;‘ 184.5f71.5 n&/d1 fasting glucose; 9.2f2.1% HbAlc; 144f20 mmHg SBP, 84&10.6 mmHg DBP; 93.6*31 ml/min GFR; 17.5f38.9
72nd EAS Congress
56
(coronary heart disease (CHD), stroke, or ischemic vessel disease of the limbs). The patients were divided into two groups upon postprandial TG elevation: Group I (7 patients) with low postprandial lipaemia (elevation of TG to maximum 1.6 multiple fasting TG concentration). Group II (11 patients) with postprandial hyperlipaemia (elevation of TG more than 1.6 multiple fasting TG concentration). Both groups were significantly different in TG levels at time 4 (1.8f0.71 vs. 2.9f0.88 mmoV1,p < 0.05) and time 6 (2.OjzO.85vs. 2.9~!~0.88mmol/l, p < 0.05) after the test breakfast, in area under curve (AUC) of TG (15.5f6.55 vs. 20.1f5.71, p < 0.05), in renal functions (urea 9.Ozb4.29vs. 4.7h1.32 mmoY1,creatinine 125.3h19.51 vs. 90.8k11.32 mmol/l) and in incidence of arterial hypertension and CHD (71.4% vs. 18.2%). AUC TG was equal to TG concentration at time 0. Both groups were not different in other observed parameters of lipid metabolism, diabetic control and treatment nor in other biochemical parameters. Conclnsions: Our results are partly compatible to published papers, which show a close relation of fasting and postprandial TG levels. Higher incidence of late macrovascular complications, arterial hypertension and renal handicap in group with lower postprandial lipaemia can be falsed by scarcity of tested patients and it should be studied. IP36 COMPARISON
BETWEEN PERINDOPRIL AND CANDESARTAN IN HYPERTENSIVE PATIENTS WITH TYPE 2 DIABETES: EVALUATION OF LIPID PROFILE AND LP (a)
G. Derosa, A. Mugellini, R. Fogari. Department of Internal Medicine and Medical Therapy, IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy mose of the Study: This study evaluated the impact of perindopril (P) and candesartan (C) on Fast PlasmaGlucose (FPG), lipid profile (Total Cholesterol (TC). LDL-Cholesterol (LDL-C), HDL-Cholesterol, Triglycerides) and Lipoprotein (a) (Lp (a)) in hypertensive (Sistolic Blood Pre&rre (SBP) > 130 mmHg and Diastolic Blood Pressure (DBP) > 85 mmHg) patients with type 2 diabetes. Methods: We evaluated 96 hypertensive patients with type 2 diabetes with normal lipid profile, and in good glucose control. We administered perindopril, 4 mg/day or candesartan, 8 mg/day, over a period of 6 months, in randomized, double-blind clinical trial. Summary of Results: We saw a significant variation from basaline to the sixth month during the treatment with P in SBP (147f6 vs 134f5 mmHg, p < O.Ol), DBP (94f4 vs 83f3.2 mmHg, p < O.Ol), FPG (155ltl5 vs 140f15 mg/dl, p < 0.05), TC (180f15 vs 168flO mg/dl, p < 0.05), LDLC (120f18 vs 106z.tlO mg/dl, p < 0.05), and in Lp(a) (29&12 vs 24&6 mg/dl, p < 0.05); during the treatment with C in SBP (148f6 vs 13615 mmHg, p < O.Ol), and in DBP (93f5 vs 85f3.8 mmHg, p < 0.01). When we interrumpted P and C therapy for 1 month, we observed a tendency to come back to the basaline values, and only SBP with both P and C had still significant values (p < 0.05). Conclusions: Perindopril and candesartan are effective to lower blood pression. Perindopril showed an improvement on some metabolic parameters compared to candesartan. This improvement could be due to his action on insulin sensitivity, with an increase of peripheral glucose utilization and reduction of lipid profile and Lp(a), even if it can not be excluded a direct action of perindopril on lipid and Lp (a) metabolism. w
EFFECTS OF FOSINOPRIL ON LIPID PROFILE AND Lp(a) IN NORMOTENSIVE PATIENTS WITH TYPE 2 DIABETES AND MICROALBUMINURIA
G. Derosa, A. Mugellini, R. Fogari. Department of Internal Medicine and Medical Therapy, IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy
mg/dl, p < 0.05), LDL-C (124&10 vs 114fll mg/dl, p < 0.05), Lp(a) (24flO vs 19f7.5 mg/dl, p < 0.05), and in AER (123f31 vs 68 + 21 r&/24 h, p < 0.01). When we interrumpted fosinopril therapy for 1 month, we observed a tendency to come back to the basaline values. Conclusions: Fosinopril treatment gave a reduction of microalbumimnia and it also showed to improve lipid profile and Lp (a) in type 2 diabetics. This suggests that fosinopril, lowering pmteinuria, achieved a improvement in lipid profile and Lp (a). It is possible that this action was not only related to the reduction in protemuria but to some other, more direct action of fosinopril on lipid and Lp (a) metabolism. Ip381 ELEVATED SERUM LIPOPROTEIN(a) LEVELS IN TYPE 1 AND TYPE 2 DIABETIC PATIENTS AMONG MALAYSIAN MALAYS
H.M. Nawawi, M. Muhajir, C.K. Yeo, W.M. Wan Naxaimoon, K. Yusoff, B.A.K. Khalid. Faculty of Medicine, Hospital Universiti Kebangsaan Malaysia (HUKMJ Kuala Lumpur. Malaysia
Lipoprotein (a) [Lp(a)] is a potential risk factor for coronary heart disease (CAD) in patients with diabetes mellitus (DM). Studies on serum Lp(a) in DM have revealed controversial results. The objective of this study was to examine and compare serum Lp(a) concentration of type 1 and type 2 diabetic patients among Malaysian Malays. We studied a total of 26 type 1 (11 males, 15 females, mean + SD age (years) = 31.8f8.0) and 107 type 2 Malay diabetic patients (52 males, 55 females, age = 42.9f10.6), and 126 non-diabetic normocholesterolaemic Malay controls (56 males, 70 females, age = 43.4h8.4). Patients were subdivided into the hypercholesterolaemic [HC] (TC > 5.7 mmol/L) and normocholestemlaemic [NC] (TCc5.7 mmol/L) subgroups. Serum Lp(a) was measured by an immunoturbidimetric method (Roche Diagnostics. Cobas Mira). Fasting lipid profile, glucose, HbAlc and urinary albumin were also determined: There was significantly higher serum Lp(a) concentration in all type 1 diabetic patients compared to controls (p
ERYTHROCYTE SEDIMENTATION RATE (ESR), AN MARKER, MAY BE AN OLD CHEAP INFLAMMATION INDICATOR OF ATHEROSCLEROSIS IN DIABETIC PEOPLE?
0. Giampietro, E. Boldrini, G. Forotti, E. Matteucci, A. Clerico. Purpose
of the Study: This study evaluated Fast Plasma Glucose (FPG),
lipid profile Total Cholesterol (TC), LDL-Cholesterol (LDL-C), HDLCholesterol, Triglycerides) and Lipoprotein (a) (Lp (a)) in normotensive (Sistolic Blood Pressure (SBP) < 130 mmHg and Diastolic Blood Pressure @BP) < 85 mmHg) pauents’with type 2 diabetes and microalbuminuria (AER), during therapy with fosinopril and aider its halt. Methods: We enrolled 120 normotensive patients with type 2 diabetes and microalbuminuria with normal lipid profile, and in good glucose control. We administered fosinopril, 10 mg/day over a period of 6 months. Summary of Results: We noted a significant variation from basaline to the sixth month of this treatment in SBP (125f4.1 vs 119f5 mmHg, p < O.Ol), DBP (80f4.8 vs 74f4.5 mmHg, p < 0.05), TC (186&11 vs 176flO
Dipartimento di Medicina Interna, Universita di Pisa, Italy
Int&umnation seems to play a role in atherosclerosis. Thus, in addition to C-reactive protein (CRP), may be of interest to measure different intlammation proteins in risk individuals. We measured the 1st hour ESR serum fibrinogen (sFB), CRP, C3c and C4 complement fractions, mucoproteins (acidal glycoprotein, alG), total proteins (sTP) and fractions, leucocyte count (WCC) together with serum total (T-Ch) and HDL-cholesterol (HDLCh), triglycerides (TG), homocysteine (tHcy), Lp(a) in 112 type 2 diabetic uatients (61.3f9.7 age vrs; 30.7f6.2 Kg/m2 BMI: 11.4f9.9 vrs diabetes duration;‘ 184.5f71.5 n&/d1 fasting glucose; 9.2f2.1% HbAlc; 144f20 mmHg SBP, 84&10.6 mmHg DBP; 93.6*31 ml/min GFR; 17.5f38.9
72nd EAS Congress