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Annals of Clinical & Laboratory Science 37:158-166 (2007)
© 2007 Association of Clinical Scientists

Decrease in Inflammatory Cardiovascular Risk Markers in Hyperlipidemic Diabetic Patients Treated with Fenofibrate

Ta-Jen Wu1, Horng-Yih Ou1, Chien-Wen Chou3, Shu-Hwa Hsiao2, Chia-Yin Lin2 and Pai C. Kao4
1 Department of Internal Medicine and 2 Department of Pharmacy, National Cheng Kung University Hospital, Tainan, Taiwan; 3 Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan; 4 Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA

Address correspondence to Pai C. Kao, Ph.D., Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; e-mail kao.pai{at}mayo.edu.

The goal was to investigate the effect of micronized fenofibrate, a hypolipidemic drug, on inflammatory markers and proinsulin in patients with type 2 diabetes who had hyperlipidemia. Thirty-nine patients were treated with micronized fenofibrate (200 mg/day for 12 wk). Erythrocyte sedimentation rate (ESR), fibrinogen, high-sensitivity C-reactive protein (hs CRP), and proinsulin levels were measured at baseline and after 12 wk of therapy. Micronized fenofibrate significantly reduced serum triglyceride, cholesterol, and uric acid levels (all p <0.0001) and increased high-density lipoprotein (HDL)-cholesterol (p <0.001) and creatinine levels (p <0.0001). Micronized fenofibrate also significantly decreased fibrinogen (421 ± 152 vs 344 ± 81 mg/dl, p <0.001), hs-CRP (3.3 ± 3.3 vs 2.1 ± 1.8 mg/L, p <0.01), and ESR (19.1 ± 24.8 vs 9.7 ± 8.7 mm/hr, p <0.01), but did not change proinsulin levels. The correlations among changes of hs-CRP, fibrinogen, and ESR were high. Although correlation among the decreases in inflammatory markers (ESR, fibrinogen, and hs-CRP) was significant, there was no significant correlation between the changes of lipid profile and inflammatory markers. In conclusion, after 12 wk, micronized fenofibrate therapy significantly decreased 3 inflammatory markers (hs-CRP, ESR, and fibrinogen) and improved the lipid profile by decreasing serum triglyceride, cholesterol, and non–HDL-cholesterol levels and increasing HDL-cholesterol; however, it did not change serum proinsulin level, a pancreatic stress marker.

Keywords: erythrocyte sedimentation rate, fenofibrate, hs-CRP, fibrinogen, proinsulin, diabetes mellitus

Abbreviations: CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; FIELD, fenofibrate intervention and event lowering in diabetes; FPG, fasting plas ma glucose; HDL, high-density lipoprotein; hs-CRP, high-sensitivity C-reactive protein; PPAR{alpha}, peroxisome proliferator–activated receptor-{alpha}.






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