The effect of fenofibrate on serum paraoxonase activity and inflammatory markers in patients with combined hyperlipidemia

Abstract

Background. Lipid lowering therapy with statins is beneficial because of improvement in lipoprotein concentrations and additional pleiotropic effects. However, less is known about the pleotropic effect of fibrates. Aim. To investigate the effects of fenofibrate therapy on inflammatory markers and serum paraoxonase activity in patients with combined hyperlipidemia in addition to their lipid lowering effects. Methods. Fifty patients (18 women, 32 men, mean age 50±8.7 years) with a history of combined hyperlipidemia and coronary artery disease were enrolled into the study. Serum lipids, inflammatory markers (high sensitivity C-reactive protein (hs-CRP) and fibrinogen levels) and paraoxonase levels were determined before and after two months of 250 mg per day of fenofibrate treatment. Results. Fenofibrate decreased plasma fibrinogen level by 41% (from 3.9±0.9 mg/dl to 2.3±0.48 mg/dl, p<0.0001) and hs-CRP level by 71% (from 1.28 mg/dl to 0.36 mg/dl; p<0.0001). Changes in hs-CRP levels were not correlated with the changes in lipid levels. Compared with baseline, serum paraoxonase level was significantly increased after fenofibrate treatment (from 200±77U/L to 232±82U/L; p<0.001). We found a significant correlation between changes in HDL cholesterol and paraoxonase activity after two months of treatment (r=0.46, p=0.018). Conclusion. This study demonstrates that beyond improving lipids and lipoprotein levels, fenofibrate treatment increases paraoxonase activity and decreases inflammatory markers in patients with combined hyperlipidemia.