Effect of a six month gemfibrozil treatment and dietary recommendations on the metabolic risk profile of visceral obese men.

The aim of the present study was to investigate the effects of a 6 month gemfibrozil treatment. A sample of 64 visceral obese men (age 46+/-6 y; body mass index 31+/-3 kg/m(2); waist circumference 104+/-7 cm; mean+/-s.d.) who received dietary recommendations. Subjects were randomly assigned to receive a placebo (n=32) or gemfibrozil (1200 mg/day) (n=32). In both placebo and gemfibrozil treated groups, significant reductions were noted in body weight, fat mass, waist circumference and visceral adipose tissue area measured by computed tomography (0.0001<P<0.05). Plasma cholesterol (CHOL) and apolipoprotein B (apo B) levels were also decreased in both groups (P<0.01) whereas plasma high density lipoprotein (HDL) and HDL-3-CHOL levels were only significantly (P<0.01) increased in the gemfibrozil-treated group. After the 6 month treatment period, gemfibrozil-treated men displayed significantly lower plasma triglycerides (TG) levels, compared to those who received the placebo (P<0.01). Finally, both fasting plasma insulin concentration and insulin area measured during an oral glucose load were significantly decreased only in the placebo group (P<0.05). Taken together, these results suggest that the improvement in plasma lipid/lipoprotein profile observed in gemfibrozil treated visceral obese men seems to be independent from changes in adipose tissue mass and in visceral fat accumulation. Furthermore, improvements in the plasma lipoprotein profile produced by gemfibrozil therapy appear to be independent from changes in indices of plasma glucose-insulin homeostasis.