The Effect of Fenofibrate Therapy on Lipid Profile, CRP and Fibrinogen Levels in Type II Diabetic Patients with Combined Hyperlipidemia

Structural and functional changes in lipoproteins associated with diabetes substantially contribute to the increased risk of cardiovascular disease. The aim of this study was to investigate the efficacy of a fibrate derivate fenofibrate, in type II diabetic patients with combined hyperlipidemia who frequently have elevated levels of fibrinogen and C-reactive protein (CRP).
METHODS
Forty-seven patients who were followed for combined hyperlipidemia refractory to diet regulation of at least 3 months and were free of coronary artery disease were enrolled in this study. Fifteen of the patients had diabetes mellitus type II. All patients received fenofibrate therapy (250 mg once a day PO) for 6 months. Serum lipid profiles, CRP and fibrinogen levels, whole blood counts, urine and blood chemistry analyses were tracked during therapy. At the end of 6 months, efficacy and side effects were evaluated. Diabetic and non-diabetic patients were compared according to their response to fenofibrate therapy.
RESULTS
At the end of 6 months, there were favourable results in respect to lipid profiles, and CRP and fibrinogen levels in all patients. There were statistically significant reductions in the serum levels of total-cholesterol (-%9), triglycerides (-%58), and LDL (-%17) in both groups. The levels of HDL and apo A1 were significantly elevated. The changes observed in lipoprotein levels were quite similar in diabetic and non-diabetic group. Baseline fibrinogen levels were sligthly higher in diabetics (378±82 mg/dl vs 350±76 mg/dl, p>0,05). After treatment fibrinogen levels decreased significantly in both diabetic (16%) and nondiabetic patients (12%). At baseline the CRP levels were also slightly higher in diabetics (0,855( 0,681 mg/dl vs 0,578( 0,584 mg/dl; p=0,05). In both groups CRP levels decreased significantly (54% in diabetics and 35% in non-diabetics). There were no significant adverse events during the study.
CONCLUSION
Fenofibrate is an efficient and safe antihyperlipidemic agent in the treatment of both diabetic and non-diabetic patients with combined hyperlipidemia. Fenofibrate may also be a possible antiatherosclerotic agent due to both CRP and fibrinogen lowering effects.