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Postprandial effects of long-term niacin/laropiprant use on glucose and lipid metabolism and on cardiovascular risk in patients with polycystic ovary syndrome.
- Source :
-
Diabetes, obesity & metabolism [Diabetes Obes Metab] 2014 Jun; Vol. 16 (6), pp. 545-52. Date of Electronic Publication: 2014 Feb 09. - Publication Year :
- 2014
-
Abstract
- Aim: This study investigated the effect of long-term niacin/laropiprant therapy on CV risk and IR in obese women with PCOS.<br />Methods: In this double-blind randomized placebo-controlled trial, 13 and 12 PCOS women completed a 12 week course of niacin/laropiprant or placebo, respectively. Fasted subjects had an endothelial function test (EndoPat2000) and then consumed a mixed meal with blood sampled postprandially for 6 h before and after intervention.<br />Results: By 12 weeks, niacin/laropiprant lowered low-density lipoprotein cholesterol (LDL-c) (13%) and increased HDL-c (17%). Despite a reduction in fasting triglycerides (21%), the drug had no effect on their postprandial rise (2.69 ± 1.44 vs. 2.49 ± 1.14 mmol/l, p = 0.72). However, following the mixed meal, plasma glucose area under the response curve increased from 13.1 ± 2.9 to 14.0 ± 2.8 mmol/l, p = 0.05, as a consequence of both increased insulin resistance [HOMA-IR: 2.2 (1.2, 4.2) vs. 3.8(1.3, 5.5), p = 0.02] and a reduced acute insulin response to glucose [424 (211, 975) vs. 257(122, 418) pmol/mmol, p = 0.04]. Niacin/laropiprant did not improve RHI (1.97 ± 0.40 vs. 2.05 ± 0.58, p = 0.33) or hsCRP.<br />Conclusions: In PCOS, niacin/laropiprant had a significant negative impact on postprandial glucose and no improvement in postprandial hypertriglyceridaemia, with at least the former mediated through increased IR and reduced β-cell function. This data may help explain why the improvement in fasting lipids has not translated into improved CV risk markers in PCOS.<br /> (© 2014 John Wiley & Sons Ltd.)
- Subjects :
- Adult
Blood Glucose metabolism
Cardiovascular Diseases metabolism
Cholesterol, HDL blood
Cholesterol, LDL blood
Double-Blind Method
Drug Therapy, Combination
Female
Humans
Hypertriglyceridemia drug therapy
Hypertriglyceridemia metabolism
Hypolipidemic Agents administration & dosage
Postprandial Period drug effects
Postprandial Period physiology
Risk Reduction Behavior
Treatment Outcome
Triglycerides blood
Young Adult
Blood Glucose drug effects
Indoles administration & dosage
Lipid Metabolism drug effects
Niacin administration & dosage
Polycystic Ovary Syndrome drug therapy
Polycystic Ovary Syndrome metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 1463-1326
- Volume :
- 16
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Diabetes, obesity & metabolism
- Publication Type :
- Academic Journal
- Accession number :
- 24401089
- Full Text :
- https://doi.org/10.1111/dom.12255