The observed effect was robust in sensitivity analyses and independent of fibrate dose .
The present meta- analysis suggests that fibrate therapy increases circulating levels of adiponectin .
BACKGROUND Several lines of evidence have indicated the insulin-sensitizing , anti-diabetic and anti-atherosclerotic properties of adiponectin , as well as the inverse association between circulating levels of this adipokine and development of cardiovascular outcomes .
Improvement of adiponectin status has been reported as a pleiotropic effect of fibrate therapy , but the findings have not been conclusive .
OBJECTIVE To systematic ally review and meta-analyze available evidence from r and omized placebo-controlled trials ( RCTs ) on the impact of fibrate therapy on circulating levels of adiponectin .
Peroxisome Proliferator–Activated Receptor Ligand Bezafibrate for Prevention of Type 2 Diabetes Mellitus in Patients With Coronary Artery Disease
Background —Recent studies have shown that type 2 diabetes is preventable by both lifestyle interventions and medications that influence primary glucose metabolism . Whether pharmacological interventions that influence primary lipid metabolism can also delay development of type 2 diabetes is unknown . The goal of this study was to evaluate the effect of the peroxisome proliferator – activated receptor lig and bezafibrate on the progression of impaired fasting glucose phase to type 2 diabetes in patients with coronary artery disease over a 6.2-year follow-up period . Methods and Results —The study sample comprised 303 nondiabetic patients 42 to 74 years of age with a fasting blood glucose level of 110 to 125 mg/dL ( 6.1 to 6.9 mmol/L ) . The patients received either 400 mg bezafibrate retard ( 156 patients ) or placebo ( 147 patients ) once a day . No patients were using statins , and use of ACE inhibitors , which also reduce diabetes incidence , was relatively low . During follow-up , development of new-onset diabetes was recorded in 146 patients : in 80 ( 54.4 % ) from the placebo group and 66 ( 42.3 % ) from the bezafibrate group ( P = 0.04 ) . The mean time until onset of new diabetes was significantly delayed in patients on bezafibrate compared with patients on placebo : 4.6±2.3 versus 3.8±2.6 years ( P = 0.004 ) . Multivariate analysis identified bezafibrate treatment as an independent predictor of reduced risk of new diabetes development ( hazard ratio , 0.70 ; 95 % CI , 0.49 to 0.99 ) . Other significant variables associated with future overt type 2 diabetes in patients with impaired fasting glucose were total cholesterol level ( hazard ratio , 1.22 ; 95 % CI 1.0 to 1.51 ) and body mass index ( hazard ratio , 1.10 ; 95 % CI , 1.05 to 1.16 ) . Conclusions —Bezafibrate reduces the incidence and delays the onset of type 2 diabetes in patients with impaired fasting glucose . Whether the combination of bezafibrate with other recommended drugs for secondary prevention ( statins and ACE inhibitors ) would be as efficacious as suggested by our results remains to be determined
The observed effect was robust in sensitivity analyses and independent of fibrate dose .
The present meta- analysis suggests that fibrate therapy increases circulating levels of adiponectin .
BACKGROUND Several lines of evidence have indicated the insulin-sensitizing , anti-diabetic and anti-atherosclerotic properties of adiponectin , as well as the inverse association between circulating levels of this adipokine and development of cardiovascular outcomes .
Improvement of adiponectin status has been reported as a pleiotropic effect of fibrate therapy , but the findings have not been conclusive .
OBJECTIVE To systematic ally review and meta-analyze available evidence from r and omized placebo-controlled trials ( RCTs ) on the impact of fibrate therapy on circulating levels of adiponectin .