OBJECTIVE -Increased postprandial lipemia is part of diabetic dyslipidemia and is associated with accelerated atherosclerosis. We investigated the effects of the peroxisome proliferatoractivated receptor-␥ agonist rosiglitazone on postprandial lipemia in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS -A randomized, 8-week, crossover, placebocontrolled, double-blind trial was performed in which rosiglitazone at 4 mg was administrated twice daily in 19 patients with type 2 diabetes.

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... andardized 6-h oral fat-loading tests were performed after each treatment period. Postprandial curves were calculated as the total area under the curve (AUC) and the incremental area under the curve (dAUC). RESULTS -Rosiglitazone did not change fasting plasma triglycerides compared with placebo (1.97 Ϯ 0.22 vs. 1.88 Ϯ 0.20 mmol/l, respectively) but decreased postprandial triglyceride levels, leading to significantly lower triglyceride dAUC (Ϫ37%, P Ͻ 0.05), without changing total triglyceride AUC. Significant postprandial triglyceride reductions in the chylomicron fraction (Svedberg flotation rate [Sf] Ͼ400) were achieved with rosiglitazone, which resulted in a significant lower triglyceride AUC (Ϫ22%) in this fraction. The postprandial triglyceride increase in VLDL1 (Sf 60 -400) was also lower after rosiglitazone (Ϫ27%), but this did not result in a significant lower triglyceride AUC. In VLDL2 (Sf 20 -60), there were no significant differences in triglyceride AUC and triglyceride dAUC between rosiglitazone and placebo. Rosiglitazone decreased free fatty acid (FFA) AUC (Ϫ12%) and FFA dAUC (Ϫ18%) compared with placebo. CONCLUSIONS -Rosiglitazone improves the metabolism of large triglyceride-rich lipoproteins and decreases postprandial FFA concentrations in type 2 diabetes. This may have clinical implications, as these effects may contribute to cardiovascular risk reduction. Abbreviations: ALT, alanine transferase; apoB, apolipoprotein B; AST, aspartate aminotransferase; AUC, area under the curve; dAUC, incremental AUC; FFA, free fatty acid; LPL, lipoprotein lipase; PPAR-␥, peroxisome proliferator-activated receptor-␥; TRL, triglyceride-rich lipoprotein; TZD, thiazolidinedione. A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.