RESUMO
OBJECTIVE: To evaluate the fibrinogen and lipids response to diet plus bezafibrate in insulin-resistant patients with arterial hypertension and mixed hyperlipidemia. METHODS: A randomized double blind parallel design was used during a 90 days treatment period. Fibrinogen, lipids, insulin and peptide C assays as well as a glucose tolerance test were done at the start and end of treatment. The 28 patients received a hypolipemic diet low in refined sugars with bezafibrate added (400 mg/day) in 15 and a placebo in 13. RESULTS: The groups were similar in age, blood pressure and BMI. At the end of treatment, fibrinogen, cholesterol, triglycerides and LDL-C were lower in both groups as compared to the initial values, but only in the bezafibrate group there were: a) significant decrease in triglycerides (64 mg/dL, p 0.01); and b) marginal changes in fibrinogen (decreased 35 mg/dL, p = 0.09), total cholesterol (decreased 26 mg/dL, p = 0.10) and glucose/insulin ratio (increased from 4.4 to 5.2, p = 0.09). Bezafibrate lowered slightly the insulin level but did not affect peptide C. A correlation of changes in fibrinogen levels and the 60 min insulin concentration in the glucose tolerance test was higher in the bezafibrate group (r = 0.61) than in the placebo group (r = 0.23). CONCLUSIONS: In insulin resistant patients with high cardiovascular risk, bezafibrate and a placebo added to a hypolipemic diet decreased plasma fibrinogen. Bezafibrate lowered significantly the levels of triglycerides in these patients.
