European Heart Journal Advance Access originally published online on May 4, 2005
European Heart Journal 2005 26(19):2032-2038; doi:10.1093/eurheartj/ehi310
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Effect of bezafibrate on incidence of type 2 diabetes mellitus in obese patients
1Cardiac Rehabilitation Institute, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel
2Bezafibrate Infarction Prevention Study Coordinating Center, Neufeld Cardiac Research Institute, The Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel
Received 2 September 2004; revised 17 February 2005; accepted 7 April 2005; online publish-ahead-of-print 4 May 2005.
* Corresponding author. Tel: +972 3 5302578; fax: +972 3 5303084. E-mail address: altenen{at}post.tau.ac.il
Aims To assess the effect of fibric acid derivative bezafibrate on incidence of type 2 diabetes in obese patients over a median 6.3 years follow-up period.
Methods and results The study sample comprised 339 non-diabetic obese patients (body mass index 
30.0 kg/m2) aged 42–74. Patients received either bezafibrate retard 400 mg (178 patients) or placebo (161 patients) once daily. Development of new diabetes was recorded in 98 patients: in 56 (37.0%) from the placebo group vs. 42 (27.1%) from the bezafibrate group, (P log-rank=0.01). The median time (interquartile range) until onset of new diabetes was significantly delayed in patients on bezafibrate when compared with those on placebo: 4.0 (2.1–5.0) vs. 2.0 (0.5–3.5) years, P=0.002. Multivariable analysis identified bezafibrate treatment as an independent predictor of reduced risk of new diabetes with hazard ratio (HR) 0.59 [95% confidence interval (CI) 0.39–0.91]. Other significant variables associated with future overt type 2 diabetes in obese patients were triglycerides (50 mg/dL increment) with HR 1.15 (95% CI 1.02–1.28) and fasting glucose (10 mg/dL increment) with HR 2.27 (95% CI 1.83–2.81).
Conclusion Bezafibrate, when compared with placebo, reduced the incidence and delayed the onset of type 2 diabetes in obese patients over a long-term follow-up period.
Key Words: Obesity • Diabetes mellitus • Prevention • Bezafibrate
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