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 .
Effect of fenofibrate and niacin on intrahepatic triglyceride content, very low-density lipoprotein kinetics, and insulin action in obese subjects with nonalcoholic fatty liver disease.
CONTEXT Nonalcoholic fatty liver disease is associated with risk factors for cardiovascular disease , particularly increased plasma triglyceride ( TG ) concentrations and insulin resistance . Fenofibrate and extended release nicotinic acid ( Niaspan ) are used to treat hypertriglyceridemia and can affect fatty acid oxidation and plasma free fatty acid concentrations , which influence intrahepatic triglyceride ( IHTG ) content and metabolic function . OBJECTIVE The objective of the study was to determine the effects of fenofibrate and nicotinic acid therapy on IHTG content and cardiovascular risk factors . EXPERIMENTAL DESIGN AND MAIN OUTCOME MEASURES : We conducted a r and omized , controlled trial to determine the effects of fenofibrate ( 8 wk , 200 mg/d ) , Niaspan ( 16 wk , 2000 mg/d ) , or placebo ( 8 wk ) on IHTG content , very low-density lipoprotein ( VLDL ) kinetics , and insulin sensitivity . SETTING AND PARTICIPANTS Twenty-seven obese subjects with nonalcoholic fatty liver disease ( body mass index 36 + /- 1 kg/m(2 ) , IHTG 23 + /- 2 % ) were studied at Washington University . RESULTS Neither fenofibrate nor Niaspan affected IHTG content , but both decreased plasma TG , VLDL-TG , and VLDL-apolipoprotein B concentrations ( P < 0.05 ) . Fenofibrate increased VLDL-TG clearance from plasma ( 33 to 54 ml/min ; P < 0.05 ) but not VLDL-TG secretion .  Niaspan decreased VLDL-TG secretion ( 27 to 15 micromol/min ; P < 0.05 ) without affecting clearance . Both fenofibrate and Niaspan decreased VLDL-apolipoprotein B secretion ( 1.6 to 1.2 and 1.3 to 0.9 nmol/min , respectively ; P < 0.05 ) . Niaspan reduced hepatic , adipose tissue , and muscle insulin sensitivity ( P < 0.05 ) , whereas fenofibrate had no effect on insulin action . CONCLUSIONS Fenofibrate and Niaspan decrease plasma VLDL-TG concentration without altering IHTG content . However , the mechanism responsible for the change in VLDL-TG concentration is different for each drug ; fenofibrate increases plasma VLDL-TG clearance , whereas nicotinic acid decreases VLDL-TG secretion
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 .