The Role Of Fibrates In Lipid Lowering Therapy With Type2Diabetes Patients And DPP-4Inhibitors And GLP-1Receptor Agonists Effect On Lipids In Type2Diabetes

PART ONE：THE ROLE OF FIBRATES INLOWERING THERAPY WITH TYPE2DIABETESPATIENTSaccording to the Chinese Diabetes Society survey, For nearly30years,China’s adult diabetes prevalence rate rose to0.7%from9.7%, of whichabout95%of people with diabetes for type2diabetes. The biggest hazardis chronic complications of diabetes, and this gives life of patients andsociety a heavy burden on the health care system. The major complicationsof diabetes are chronic vascular disease (heart disease, hypertension,cerebrovascular accident and lower extremity vascular disease),microvascular disease (diabetic retinopathy, diabetic nephropathy),neuropathy,and so on.among which cardiovascular complications are morecommon, it is one of the leading causes of death in diabetic patients.UKPDS study showed that75percent of type2diabetes die ofcardiovascular disease, and elevated LDL-C and the decline in HDL-Care the first and second risk factors lead to death[1]. The study showed thatlow HDL-C and high triglyceride (TG) levels are a major risk factor forcardiovascular events residual risk, while lowering LDL-C at the sametime raise HDL-C,lower triglycerides to further reduce cardiovascular events. For patients with lipid-lowering therapy in patients with type2diabetes, the most commonly used statins and fibrates.statin drugs canignificantly lower LDL-C and other cardiovascular events in primary andsecondary prevention, but the residual risk for cardiovascular eventsremains high; while fibrates drugs not only can significantly reduce therisk of cardiovascular events still remaining can effectively improve isletfunction and insulin resistance. PART TWO： DPP-4INHIBITORS AND GLP-1RECEPTOR AGONISTS EFFECT ON LIPIDS IN TYPE2DIABETESaccording to the Chinese Diabetes Society survey, For nearly30years,China’s adult diabetes prevalence rate rose to0.7%from9.7%, of whichabout95%of people with diabetes for type2diabetes.More than half ofdyslipidemia associated with type2diabetes by clinical. Studies showedthat75percent of type2diabetes die of cardiovascular disease, Anddyslipidemia is an independent risk factor for coronary heart disease indiabetes[1,2]. Therefore, in patients with type2diabetes should be strictlycontrolled abnormal lipid metabolism to reduce the risk of cardiovascularevents, And The relationship between lipid metabolism and incretin whichcan regulate blood sugar are inseparable.Incretin hormone secretion canimprove islet function by promoting insulin secretion, inhibit glucagon,increased insulin sensitivity and other aspects of regulating blood lipids.Currently incretin is main including glucagon-like peptide-1(GLP-1)and glucose-dependent insulinotropic polypeptide (GIP), but the half-lifeof biological activity only2minutes, Dipeptidyl peptidase4(DPP-4) caninactivated it rapidly. DPP-4inhibitors may be effective in preventing thedegradation of incretin and improve it level and the GLP-1receptor agonistmay bind and activate the GLP-1receptors, thereby generating theendogenous GLP-1is similar to physiological effects.