**2.2.3 ACCORD-Lipid & ACCORD-EYE study**

In the ACCORD-Lipid study, the inhibitory effects of 3 intensified/standard medicinal therapies (blood sugar, blood pressure, lipids) on compound cardiovascular events were investigated in approximately 10,000 type II diabetics with mild dyslipidemia and the high risk of cardiovascular disease (CVD) under the auspices of the National Institutes of Health (NIH). Lipid intervention was performed in 5,518 patients: intensified (simvastatin 20mg + micronized fenofibrate 200mg) and standard (simvastatin 20mg + placebo) therapies. The mean follow-up was 4.7 years. In the fenofibrate-combined group, the incidence of cardiovascular events was inhibited by 8%, although there was no significant difference. In patients with a pre-treatment TG level of 204 mg/dL or more and HDL-C level of 34 mg/dL or less, significant inhibitory effects on events were confirmed (-31% (p<0.05), NNT=20) (ACCORD Study Group et al., 2010).

In the ACCORD–EYE study, the deterioration of diabetic retinopathy was evaluated in 2,856 patients from whom informed consent was obtained (lipid intervention: 1,593 patients) among type II DM who participated in the ACCORD-Lipid study (ACCORD Study Group; ACCORD Eye Study Group et al., 2010). In the fenofibrate-combined group, intensified therapy significantly inhibited the deterioration of diabetic retinopathy (by 40%) in comparison with the simvastatin group (p=0.006). The ACCORD–EYE study, the second large-scale clinical study following the FIELD, demonstrated the inhibitory effects of fenofibrate on the deterioration of diabetic retinopathy, supporting its efficacy for diabetic retinopathy.

The inhibitory effects of fenofibrate on diabetic microangiopathy are summarized below (Table 1). In a large-scale clinical study of lipid-lowering agents, no statin exhibited any inhibitory effects on diabetic microangiopathy. Only fenofibrate inhibited the complication. Thus, fenofibrate should be recognized as a "prophylactic drug for diabetic complications", and not solely as a lipid-lowering agent.
