Does obesity influence ciprofibrate activity?
OBJECTIVE
The association of obesity and dyslipidemia, namely high triglycerides and low HDL-cholesterol levels, is well known, but, as far as we are aware, the possible influence of obesity on the efficacy of current hypolipidemic drugs has never been studied. Therefore, we investigated the relationship between obesity and ciprofibrate efficacy.


METHODS
This was a post-hoc analysis of an open-label study with 6-month therapy of ciprofibrate carried out in the Atherosclerosis Out-Patient Clinic of Coimbra University Hospital. Eligible patients were 30 to 70 years old with cholesterol > 6.2 mmol L-1 and/or triglycerides > 2.23 mmol L-1. A sequential sample of 20 patients was selected but only 18 completed the study. After at least one month of diet or washout period all participants were given 100 mg day-1 of ciprofibrate. Triglycerides, total (TC) and HDL-cholesterol (HDL-C), apoproteins A-1, B100 and (a), and fibrinogen were measured at the beginning and at the end of the study. LDL-cholesterol (LDL-C) was calculated by the Friedewald formula.


RESULTS
Baseline and the percentage of modification with ciprofibrate (delta%) of triglycerides correlated positively with body mass index (BMI) and waist/hip ratio (WHR). Baseline HDL-C correlated negatively with BMI and WHR, but delta% correlated positively with BMI. Fibrinogen behaved differently from triglycerides. The negative correlations between BMI and WHR and the delta% of LDL-C lost power and significance in stepwise regression after the introduction of types of dyslipidemias as an independent variable.


CONCLUSIONS
Ciprofibrate may be particularly effective in obese patients with high triglycerides and low HDL-C, a subject deserving further research.
Silva
J M
JM
Serviço de Medicina II, Hospitais da Universidade de Coimbra.
Serra e Silva
P
P
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002995:Clofibric Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D058607:Fibric Acids; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood*
D058607:Fibric Acids; D000960:Hypolipidemic Agents; D002995:Clofibric Acid; C019304:ciprofibrate