Siavash Mansour, Amini Masoud
Department of Endocrinology, Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Pharm Pract. 2014 Jul;3(3):77-82. doi: 10.4103/2279-042X.141075.
Type 2 diabetes mellitus (DM-T2) is commonly associated with increased triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and low high-density lipoprotein cholesterol (HDL-C) levels. Fibrates like gemfibrozil are frequently used in diabetic patients to decrease TG and increase HDL-C levels. We compared the efficacy of Vitamin C, an antioxidant vitamin, with gemfibrozil on serum HDL-C in diabetic patients.
Type 2 diabetic patients, referred to our out-patient clinic were randomly divided into three groups. After 1 month of lifestyle and diet modifications, groups A, B, and C were prescribed 1000 mg Vitamin C, 600 mg gemfibrozil and combination of both, respectively. Before the study initiation and after 6(th) week of drug prescription, the blood samples were taken and analyzed for total cholesterol (Total-C), HDL-C, TG, fasting blood sugar (FBS), and hemoglobin A1c (HbA1c) levels.
Sixty-seven patients entered, and 50 patients (18 male, 32 female) finished the study. Overall, serum HDL-C increased significantly from 39.8 to 45.2 mg/dL in the participants (P = 0.001). HDL-C increased 6.3, 4.4 and 5.0 mg/dL in groups A, B and C, respectively (related significances were 0.017, 0.022 and 0.033, respectively). Significant decrease of serum TG and Total-C occurred in gemfibrozil and combination groups, but not in Vitamin C group. Changes in serum HDL-C between three groups were not significant (P = 0.963). We found a significant decrease in TG and Total-C in the groups B and C (P < 0.05), but no significant changes of TG, Total-C, LDL-C, FBS and HbA1c in group A (P > 0.05).
The results demonstrated that Vitamin C may have beneficial effects on HDL-C in diabetic patients without significant effects on plasma glucose or other lipid parameters; however, its role for the treatment of low HDL-C patients should be evaluated in larger studies.
2型糖尿病（DM-T2）通常与甘油三酯（TG）升高、低密度脂蛋白胆固醇（LDL-C）以及高密度脂蛋白胆固醇（HDL-C）水平降低有关。像吉非贝齐这样的贝特类药物常用于糖尿病患者以降低TG并提高HDL-C水平。我们比较了抗氧化维生素C与吉非贝齐对糖尿病患者血清HDL-C的疗效。
转诊至我们门诊的2型糖尿病患者被随机分为三组。在进行1个月的生活方式和饮食调整后，A组、B组和C组分别被给予1000毫克维生素C、600毫克吉非贝齐以及两者的组合。在研究开始前以及药物处方第6周后，采集血样并分析总胆固醇（Total-C）、HDL-C、TG、空腹血糖（FBS）和糖化血红蛋白（HbA1c）水平。
67名患者入组，50名患者（18名男性，32名女性）完成了研究。总体而言，参与者的血清HDL-C从39.8显著升高至45.2毫克/分升（P = 0.001）。A组、B组和C组的HDL-C分别升高了6.3、4.4和5.0毫克/分升（相关显著性分别为0.017、0.022和0.033）。吉非贝齐组和联合用药组血清TG和Total-C显著降低，但维生素C组未降低。三组之间血清HDL-C的变化不显著（P = 0.963）。我们发现B组和C组的TG和Total-C显著降低（P < 0.05），但A组的TG、Total-C、LDL-C、FBS和HbA1c无显著变化（P > 0.05）。
结果表明，维生素C可能对糖尿病患者的HDL-C有有益作用，而对血糖或其他血脂参数无显著影响；然而，其在治疗HDL-C水平低的患者中的作用应在更大规模的研究中进行评估。
