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 .
Beneficial effects of fenofibrate to improve endothelial dysfunction and raise adiponectin levels in patients with primary hypertriglyceridemia.
OBJECTIVE Improvement in endothelial function is predicted to improve insulin sensitivity , and this may be one mechanism by which fenofibrate decreases the incidence of coronary heart disease . We hypothesize fenofibrate improves endothelial function by enhancing insulin sensitivity . RESEARCH DESIGN AND METHODS We administered placebo or fenofibrate 200 mg daily for 8 weeks to 46 patients with primary hypertriglyceridemia ( 24 had metabolic syndrome ) . This study was r and omized , double blind , placebo controlled , and crossover in design . RESULTS Compared with placebo , fenofibrate decreased total cholesterol , non-HDL cholesterol , apolipoprotein B , and triglycerides and increased HDL cholesterol and apolipoprotein A-I ( all P < 0.001 ) while tending to decrease LDL cholesterol ( P = 0.069 ) . Fenofibrate significantly improved percent flow-mediated dilator response to hyperemia by 48 + /- 5 % ( P < 0.001 ) and lowered plasma levels of high-sensitivity C-reactive protein ( hsCRP ) relative to baseline measurements from 0.80 to 0.70 mg/l ( P = 0.001 ) and fibrinogen levels by 16 + /- 3 % ( P < 0.001 ) . Compared with placebo , fenofibrate therapy significantly increased plasma levels of adiponectin by 14 + /- 5 % ( P = 0.008 ) and increased insulin sensitivity ( assessed by quantitative insulin sensitivity check index [ QUICKI ] ) by 6 + /- 2 % ( P = 0.048 ) . There were significant correlations between percent changes in adiponectin levels and percent changes in flow-mediated dilation ( r = 0.401 , P = 0.006 ) , hsCRP ( r = -0.443 , P = 0.002 ) , or QUICKI ( r = 0.292 , P = 0.049 ) . Multivariate regression analysis showed that only changes in adiponectin levels persisted as an independent predictor of changes in flow-mediated dilation ( r = 0.504 , P = 0.013 ) . Overall , we observed similar results in 24 patients with metabolic syndrome . CONCLUSIONS Fenofibrate therapy significantly improved percent flow-mediated dilator response to hyperemia , reduced inflammation marker levels , increased adiponectin levels , and improved insulin sensitivity in hypertriglyceridemic or metabolic syndrome patients
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 .