Effect of Fenofibrate on the Level of Asymmetric Dimethylarginine in Type 2 Diabetes Mellitus

ABSTRACT However, whether the beneficial effect of fenofibrate on the endothelium is related to reduction of ADMA level in individuals with diabetes mellitus (DM) is not known, and the current study aimed to address this issue. Aim: A total of 60 patients with type 2 DM and dyslipidemia (aged 45 ± 8 years; mean ± SD) were compared to 59 healthy controls without type 2 DM and normolipidemia (aged 44 ± 9 years). Methods: Total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL) cholesterol, Apolipoprotein-A1 (Apo-A1) and Apolipoprotein-B (Apo-B) were investigated using biochemical analyzer Konelab 60i, Thermo Electron Co, USA. The levels of asymmetric dimethylarginine (ADMA), sICAM-1, sVCAM were determined by ELISA. Determination of flow mediated vasodilatation of the brachial artery was performed based on Celermajer’s guidelines and on %FMD manual (Celermajer et al., 1992; Corretti et al., 2002). The diameter of the brachial artery was measured using a 7.5 MHz transducer of Hewlett Packard 2 500 ultrasound equipment. Automatic computer software MedicaSoft. IMT.lab was applied. The DM group had significantly lower level of HDL cholesterol and significantly higher levels of total cholesterol, triglycerides, LDL-cholesterol, Apo-B, Apo-A1, ADMA, sVCAM-1, sICAM-1. The DM patients showed significantly redused % FMD of the brachial artery in comparison to the controls. (p<0.01) Therapy with 200 mg Fenofibrate for 1 month statistic significant reduced total cholesterol, triglycerides, LDL-cholesterol, Apo-B, Apo-B/Apo-A1, and ADMA. Same therapy statistical significant increased HDLcholesterol, Apo-A 1 and %FMD. These therapy don‘t change sVCAM-1 and sICAM-1. Conclusion: Treatment with fenofibrate 200 mg/d for one month statistically significant reduction in plasma levels of ADMA. (p<0.001) The present results suggest that fenofibrate improves endotheliumdependent dilation of hypertriglyceridemic individuals, and the beneficial effect of fenofibrate may be related to a reduction of the level of ADMA. Keys words: diabetes mellitus, dyslipidemia, flowmediated vasodilation, fenofibrate,