Abrogation of postprandial triglyceridemia with dual PPAR α/γ agonist in type 2 diabetes mellitus: a randomized, placebo-controlled study

Acta Diabetol. 2020 Jul;57(7):809-818. doi: 10.1007/s00592-020-01487-8. Epub 2020 Feb 6.

Abstract

Aims: Lowering postprandial lipemia may mitigate cardiovascular risk in patients with diabetic dyslipidemia. This study was aimed to investigate whether saroglitazar suppresses postprandial lipemia in patients with diabetes and dyslipidemia.

Methods: This was a 12-week, prospective, multicenter, randomized, double-blinded, placebo-controlled study of saroglitazar in patients with diabetes and dyslipidemia. Thirty patients were randomized (1:1) to receive saroglitazar 4 mg or placebo orally once daily with metformin for 12 weeks. The primary endpoint was change in plasma triglyceride (TG) area under the curve (AUC) on a standardized 8-h fat tolerance test.

Results: Thirty participants were randomized for interventions and eventually data of 19 participants qualified for per protocol analyses. Mean (SD) age in saroglitazar was 53.1 (8.8) years and 54.9 (7.7) years in placebo group. After 12 weeks, saroglitazar significantly lowered postprandial TG-AUC by - 458.3 (144.0) (- 25.7%, 95% CI - 765.1 to - 151.4) versus an increase of + 10.9 (157.9) (+ 0.5%, 95% CI - 325.6 to 347.3) mg/dL h in placebo group (P < 0.05). Saroglitazar lowered postprandial TG incremental AUC versus placebo: - 329.4 (89.9) (- 59%) versus + 80.4 (99.4) (+ 10%) mg/dL h (P < 0.05). HbA1c (%) decreased by - 0.36 (0.42) in the saroglitazar group as compared to an increase of + 1.26 (0.46) (P < 0.05) with placebo.

Conclusions: The saroglitazar treatment significantly improved postprandial TGs in people with diabetic dyslipidemia.

Trial registration: Clinical Trial Registry of India; trial Registration No.: CTRI/2015/06/005845 and Date of registration: June 02, 2015.

Keywords: Clinical trial; Diabetes; Dyslipidemias; PPARs; Triglyceride.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Double-Blind Method
  • Female
  • Humans
  • Hyperlipidemias / blood
  • Hyperlipidemias / complications
  • Hyperlipidemias / drug therapy*
  • Hypoglycemic Agents / therapeutic use*
  • India
  • Male
  • Metformin / therapeutic use
  • Middle Aged
  • PPAR alpha / agonists
  • PPAR gamma / agonists
  • Phenylpropionates / therapeutic use*
  • Placebos
  • Postprandial Period / drug effects
  • Pyrroles / therapeutic use*
  • Triglycerides / blood*

Substances

  • Hypoglycemic Agents
  • PPAR alpha
  • PPAR gamma
  • Phenylpropionates
  • Placebos
  • Pyrroles
  • Triglycerides
  • Metformin
  • saroglitazar