Fenofibrate and pioglitazone improve endothelial function and reduce arterial stiffness in obese glucose tolerant men
Open accessAbstract
Obesity is a low grade inflammatory state associated with premature cardiovascular morbidity and mortality. Along with traditional risk factors the measurement of endothelial function, insulin resistance, inflammation and arterial stiffness may contribute to the assessment of cardiovascular risk. We conducted a randomised placebo controlled trial to assess the effects of 12 weeks treatment with a PPAR alpha agonist (fenofibrate) and a PPAR gamma agonist (pioglitazone) on these parameters in obese glucose tolerant men. Arterial stiffness was measured using augmentation index and pulse wave velocity (PWV). E-selectin, VCAM-1 and ICAM-1 were used as markers of endothelial function. Insulin sensitivity improved with pioglitazone treatment (p=0.001) and, in keeping with this, adiponectin increased by 85.2% (p<0.001). Pro-inflammatory cytokine levels (TNFalpha, IL-6 and IL-1 beta) fell with both treatments (p<0.01 for TNFalpha and IL-1 beta, p<0.001 for IL-6). VCAM-1 and ICAM-1 were reduced with both treatments (p<0.001 for VCAM-1, p<0.05 for ICAM-1) and E-selectin improved with pioglitazone treatment (p=0.05). Both treatments resulted in a fall in augmentation index. PWV fell by 17.4% with fenofibrate treatment (p<0.001) and 16.3% with pioglitazone treatment (p<0.001). Pioglitazone and fenofibrate treatment of obese, glucose tolerant men reduces inflammation, improves markers of endothelial function and reduces arterial stiffness. These results suggest that treatment with PPAR agonists has potential to reduce the incidence of premature cardiovascular disease associated with obesity.
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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 [41]
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- Authors
- Ryan, K. E., McCance, D. R., Powell, L., McMahon, R., & Trimble, E. R.
- Affiliations
- Royal Victoria Hospital (GB)
- Queen's University Belfast (GB)
- Corresponding author
- Powell, L.
- ORCID
- Trimble, E.R.
- Venue
- Atherosclerosis
- Publisher
- Elsevier BV
- Published
- 2007-10
- Volume
- 194
- Issue
- 2
- Pages
- e123-e130
- ISSN
- 0021-9150 (ISSN-L)
- OpenAlex
- W1982191008
- Cited by
- 94
- References
- 31
- Citations by year
- 2025: 5 · 2024: 5 · 2023: 5 · 2022: 2 · 2021: 3 · 2020: 6 · 2019: 1 · 2018: 2 · 2017: 3 · 2016: 3 · 2015: 4 · 2014: 7 · 2013: 5 · 2012: 7
- FWCI
- 4.95
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Atherosclerosis (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Peroxisome Proliferator-Activated Receptors
- Keywords
- fenofibrate, pioglitazone, PPAR agonists, endothelial function, arterial stiffness, obesity, glucose tolerance, insulin sensitivity, adiponectin, inflammation, inflammatory cytokines, E-selectin, VCAM-1, ICAM-1, augmentation index, pulse wave velocity, cardiovascular risk
- MeSH terms
- Pioglitazone, Adult, Hypolipidemic Agents, Arteries, Blood Pressure, Double-Blind Method, Elasticity, Endothelium, Vascular, Humans, Hypoglycemic Agents, Inflammation, Male, Middle Aged, Obesity, Fenofibrate, Pulsatile Flow, Cell Adhesion Molecules, Cytokines, Thiazolidinediones, PPAR gamma
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