Conclusion : This meta‐ analysis has shown that fibrate treatment  significantly decreases fasting plasma glucose , insulin levels , and HOMA‐IR indicating additional clinical therapeutic benefits .
Aims : The aim of this meta‐ analysis of r and omized placebo‐controlled clinical trials was to assess the effect of fibrates on glycemic parameters .
Combined effect of coenzyme Q10 and fenofibrate on forearm microcirculatory function in type 2 diabetes.
Arteriopathy is the principal complication of type 2 diabetes mellitus . It develops from endothelial dysfunction , which we have hypothesised occurs in diabetes primarily as a consequence of dyslipidaemia and oxidative stress . Fenofibrate and CoQ may improve endothelial function by regulating dyslipidaemia and oxidative stress , respectively . We therefore aim ed to assess the independent and combined effects of fenofibrate and coenzyme Q(10 ) ( CoQ ) on endothelium-dependent and endothelium-independent vasodilator function of the forearm microcirculation in type 2 diabetes . Eighty dyslipidaemic type 2 diabetics were r and omized to receive fenofibrate ( 200 mg/daily ) , CoQ ( 200 mg/daily ) , fenofibrate plus CoQ ( 200 + 200 mg daily ) , or placebo for 12 weeks . Forearm microcirculatory function was assessed with venous occlusion plethysmography during the infusion of acetylcholine ( ACh ) , bradykinin ( BK ) , sodium nitroprusside ( SNP ) and N(G)-monomethyl-L-arginine ( L-NMMA ) into the brachial artery . Blood flow responses were calculated as area under the curve ( AUC ) . Fenofibrate significantly lowered plasma cholesterol , triglyceride and fibrinogen ( P<0.001 ) , and elevated HDL-cholesterol and homocysteine ( P<0.001 ) . CoQ did not change plasma isoprostanes , but significantly lowered systolic blood pressure and HbA(1c ) ( P<0.05 ) . Fenofibrate plus CoQ significantly improved ( P<0.05 ) the AUC for ACh , BK and SNP without significantly altering basal responses to L-NMMA . Fenofibrate or CoQ alone did not significantly alter blood flow responses . Improvements in blood flow were independent of changes in plasma lipids , blood pressure , homocysteine and isoprostanes , but were correlated ( P=0.013 ) with HbA(1c ) . In conclusion , in this factorial trial we found that only the combination of fenofibrate and CoQ markedly improved endothelial and non-endothelial forearm vasodilator function in dyslipidemic type 2 diabetic patients . The favourable vascular effect of this therapeutic combination could be due to increase in the bioactivity of and /or responses to endothelium-derived relaxing factors , including nitric oxide , and this may entail synergistic stimulation of peroxisome proliferator-activated receptors
Conclusion : This meta‐ analysis has shown that fibrate treatment  significantly decreases fasting plasma glucose , insulin levels , and HOMA‐IR indicating additional clinical therapeutic benefits .
Aims : The aim of this meta‐ analysis of r and omized placebo‐controlled clinical trials was to assess the effect of fibrates on glycemic parameters .