Effects of fenofibrate and simvastatin on HDL-related biomarkers in low-HDL patients
Abstract
The objective of the present study was to compare the effects of fenofibrate versus simvastatin on various HDL-related biomarkers in dyslipidemic patients with low HDL-C, in whom it is as yet unclear whether a statin or a fibrate is the most appropriate treatment. Fifty-two patients received either fenofibrate (160 mg/day) or simvastatin (40 mg/day) for 8 weeks in a randomized, double-blind, parallel group trial. Simvastatin effectively lowered plasma LDL-C and apoB levels, but did not change plasma HDL levels and HDL-related biomarkers, except for a small, significant increase in the capacity of plasma to promote SR-BI mediated cholesterol efflux. Fenofibrate did not affect plasma LDL-C levels but lowered triglycerides, and exerted a remarkable HDL-C raising activity (+22%), with patients in the lowest range of HDL-C getting the maximal benefit. The HDL-C raise was associated with a shift of HDL from large to small particles, and from LpA-I to LpA-I:A-II, which might explain the observed increase in the plasma capacity to promote ABCA1 mediated efflux with no changes in SR-BI efflux. The distinct and complementary effects of fenofibrate and simvastatin on lipid parameters and HDL-related biomarkers suggest that a combination therapy with the two drugs in dyslipidemic patients with low HDL would be fully justified.
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Fenofibrate treatment typically reduces serum triglycerides by a mean change of −93.7 mg/dL (−39.3%), increases high density lipoprotein cholesterol by +5.5 mg/dL (+12.4%), and reduces low density lipoprotein cholesterol by −17.9 mg/dL (−12.3%).
“Typical changes in serum lipids as a result of FF treatment include clinically important mean reductions of serum triglycerides (TG) by a mean change of −93.7 mg/dL (−39.3%), increases of high density lipoprotein cholesterol (HDLC) by +5.5 mg/dL (+12.4%), and reductions in low density lipoprotein cholesterol (LDLC) by −17.9 mg/dL (−12.3%).”
From Fenofibrate and metabolic syndrome (2010) · cites this paper as [34]
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- Authors
- Franceschini, G., Calabresi, L., Colombo, C., Favari, E., Bernini, F., & Sirtori, C. R.
- Affiliations
- University of Milan (IT)
- University of Parma (IT)
- Corresponding author
- Franceschini, Guido
- Venue
- Atherosclerosis
- Publisher
- Elsevier BV
- Published
- 2007-12
- Volume
- 195
- Issue
- 2
- Pages
- 385-391
- ISSN
- 0021-9150 (ISSN-L)
- OpenAlex
- W2135426425
- Cited by
- 66
- References
- 40
- Citations by year
- 2024: 2 · 2023: 3 · 2022: 2 · 2021: 3 · 2020: 1 · 2019: 2 · 2018: 6 · 2017: 1 · 2016: 7 · 2015: 3 · 2014: 5 · 2013: 8 · 2012: 4
- FWCI
- 3.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Atherosclerosis (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Keywords
- fenofibrate, simvastatin, low HDL cholesterol, dyslipidemia, LDL cholesterol, apolipoprotein B, HDL particle size, apolipoprotein A-I, triglycerides, statins, fibrates, combination therapy
- MeSH terms
- Aged, Hypolipidemic Agents, Apolipoproteins, Double-Blind Method, Female, Humans, Cholesterol, HDL, Cholesterol, LDL, Male, Middle Aged, Fenofibrate, ATP-Binding Cassette Transporters, Simvastatin, Scavenger Receptors, Class B, ATP Binding Cassette Transporter 1
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