Lu J et al.Citation1 provide data suggesting that nateglinide and acarbose can improve postprandial glucose profile to a similar extent in hypoglycemic drug-naïve patients with type 2 diabetes, while exerting different effects on lipids; acarbose reduced fasting high-density lipoprotein cholesterol (HDL-C) and triglycerides (TGs) (both fasting and postprandial) and nateglinide decreased postprandial free fatty acid (FFA) levels. A few comments may be of interest.
Apart from insulin resistance, FFAs have been associated with abdominal obesity, metabolic syndrome (MetS) and non-alcoholic fatty liver disease (NAFLD)Citation2–4, all of which are linked to increased vascular riskCitation5. Elevated plasma FFA levels were also reported to increase cardiovascular risk in healthy individualsCitation6. In this context, the authors could provide data on abdominal adiposity (i.e. waist circumference), MetS and NAFLD.
Postprandial lipemia was shown to predict vascular diseaseCitation7. An expert panel recently discussed the clinical significance and assessment of postprandial lipemiaCitation8. Lipid-lowering drugs may affect postprandial lipidsCitation9,Citation10. Therefore, the authors should mention if there were any differences in cholesterol-reducing therapy between study groups.
Declaration of financial/other relationships
This letter was written independently; no company or institution supported the authors financially or by providing a professional writer. N.K. has given talks and attended conferences sponsored by Novartis, Pfizer, MSD and Astra Zeneca. G.K. has given talks (Astra Zeneca, Abbott) and participated in advisory board meetings (Abbott, MSD).
References
- Lu J-M, Guo X-H, Lv XF, et al. Effects of nateglinide on postprandial plasma glucose excursion and metabolism of lipids in Chinese Patients with type 2 diabetes: a 4-week, randomized, active-control, open-label, parallel-group, multicenter trial. Curr Med Res Opin 2013: in press doi: 10.1185/03007995.2012.713340
- Gaggini M, Morelli M, Buzzigoli E, et al. Non-alcoholic fatty liver disease (NAFLD) and its connection with insulin resistance, dyslipidemia, atherosclerosis and coronary heart disease. Nutrients 2013;5:1544-60
- Standl E. Dysglycemia and abdominal obesity. Curr Vasc Pharmacol 2012;10:678-9
- Phillips LK, Prins JB. The link between abdominal obesity and the metabolic syndrome. Curr Hypertens Rep 2008;10:156-64
- Katsiki N, Athyros VG, Karagiannis A, Mikhailidis DP. Characteristics other than the diagnostic criteria associated with metabolic syndrome: an overview. Curr Vasc Pharmacol 2013 Apr 25 [Epub ahead of print]
- Mathew M, Tay E, Cusi K. Elevated plasma free fatty acids increase cardiovascular risk by inducing plasma biomarkers of endothelial activation, myeloperoxidase and PAI-1 in healthy subjects. Cardiovasc Diabetol 2010;9:9
- Kolovou G, Ooi TC. Postprandial lipaemia and vascular disease. Curr Opin Cardiol 2013;28:446-51
- Kolovou GD, Mikhailidis DP, Kovar J, et al. Assessment and clinical relevance of non-fasting and postprandial triglycerides: an expert panel statement. Curr Vasc Pharmacol 2011;9:258-70
- Kolovou GD, Anagnostopoulou KK, Salpea KD, et al. The effect of statins on postprandial lipemia. Curr Drug Targets 2007;8:551-60
- Kolovou GD, Anagnostopoulou KK, Kostakou PM, et al. Cholesterol ester transfer protein (CETP), postprandial lipemia and hypolipidemic drugs. Curr Med Chem 2009;16:4345-60