The estimated effects of fibrate therapy on plasma concentration and activity of PAI-1 were independent of treatment duration and changes in plasma triglyceride levels in the meta-regression analysis .
This meta- analysis of RCTs suggested that fibrate therapy does not reduce plasma concentration or activity of PAI-I. The putative benefits of fibrate therapy in patients with cardiovascular disease appear to be exerted via mechanisms independent of effects on PAI-1
OBJECTIVE The aim of this systematic review was to perform a meta- analysis of r and omized controlled trials ( RCTs ) examining the efficacy of fibrate therapy in reducing plasma concentration or activity of plasminogen activator inhibitor 1 ( PAI-1 ) .
Effects of short-term fenofibrate treatment on circulating markers of inflammation and hemostasis in patients with impaired glucose tolerance.
CONTEXT Apart from lowering lipid levels , peroxisome proliferator-activated receptor ( PPAR ) alpha activators ( fibrates ) produce many other favorable effects that may contribute to their clinical effectiveness in dyslipidemic and diabetic patients . OBJECTIVE The objective of this study was to compare the impact of a short-term treatment with fenofibrate and the American Heart Association ( AHA ) step 1 diet on systemic inflammation , hemostasis , and monocyte secretory function in relationship with their metabolic actions . DESIGN , SETTING , PARTICIPANTS , AND INTERVENTIONS This was a prospect i ve , r and omized , placebo-controlled trial involving the group of 91 ambulatory patients with impaired glucose tolerance ( IGT ) ( diagnosed on the basis of the American Diabetes Association criteria ) , r and omly divided into three groups , simultaneously treated for 30 d with the AHA step 1 diet ( n = 30 ) , micronized fenofibrate ( 267 mg/d , n = 31 ) , or placebo ( n = 30 ) . The control group included 34 age- , sex- , and weight-matched subjects with normal glucose tolerance . Eighty-six ( 95 % ) patients and all control subjects completed the study . MAIN OUTCOME MEASURES Plasma markers of inflammation and hemostasis and monocyte release of proinflammatory cytokines were measured . RESULTS Compared with subjects with normal glucose tolerance , IGT patients exhibited higher plasma levels/activities of fibrinogen , factor VII , plasminogen activator inhibitor-1 , high-sensitivity C-reactive protein , and oxidized low-density lipoproteins . Lipopolysaccharide-activated monocytes from IGT patients released significantly more TNF-alpha , IL-1beta , IL-6 , and monocyte chemoattractant protein-1 in comparison with monocytes from control subjects . Thirty-day treatment with fenofibrate but not with the AHA step 1 diet : 1 ) improved lipid/lipoprotein profile and glucose metabolism , and 2 ) reversed or alleviated all the above-mentioned abnormalities . The favorable effects of fenofibrate on plasma high-sensitivity C-reactive protein and on monocyte release of TNF-alpha , IL-1beta , IL-6 , and monocyte chemoattractant protein-1 did not correlate with its action on plasma lipids but was related to the improvement in insulin sensitivity and weakly to free fatty acid-lowering action . CONCLUSIONS Our study is the first to show that relatively small disturbances in glucose metabolism are associated with marked and multidirectional abnormalities in plasma markers of inflammation and hemostasis and in monocyte secretory function . Moreover , fenofibrate may exhibit early pleiotropic effects in patients with IGT
The estimated effects of fibrate therapy on plasma concentration and activity of PAI-1 were independent of treatment duration and changes in plasma triglyceride levels in the meta-regression analysis .
This meta- analysis of RCTs suggested that fibrate therapy does not reduce plasma concentration or activity of PAI-I. The putative benefits of fibrate therapy in patients with cardiovascular disease appear to be exerted via mechanisms independent of effects on PAI-1
OBJECTIVE The aim of this systematic review was to perform a meta- analysis of r and omized controlled trials ( RCTs ) examining the efficacy of fibrate therapy in reducing plasma concentration or activity of plasminogen activator inhibitor 1 ( PAI-1 ) .