Effects of fenofibrate and gemfibrozil on plasma homocysteine.
Fenofibrate increases plasma homocysteine. Because the concentration of plasma homocysteine depends on renal function, we postulate that increases in plasma homocysteine are a result of the known impairment of renal function caused by fenofibrate. Gemfibrozil, another fibrate, does not affect renal function. In a crossover study we tested whether gemfibrozil would raise homocysteine. 22 patients who had hypertriglyceridaemia were given 900 mg gemfibrozil or 200 mg fenofibrate daily for 6 weeks. Lipids were altered similarly, but homocysteine, creatinine, and cystatin C were raised by fenofibrate but not by gemfibrozil (p for differences between treatment effects: 0.007, 0.006, and 0.040, respectively). We propose gemfibrozil should be the fibrate of choice.
Westphal
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S
Dierkes
J
J
Luley
C
C
D000328:Adult; D000368:Aged; D003404:Creatinine / Q000097:blood; D018592:Cross-Over Studies; D055316:Cystatin C; D015891:Cystatins / Q000097:blood; D011345:Fenofibrate / Q000009:adverse effects* / Q000627:therapeutic use; D015248:Gemfibrozil / Q000009:adverse effects* / Q000627:therapeutic use; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood / Q000188:drug therapy*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged
C525030:CST3 protein, human; D055316:Cystatin C; D015891:Cystatins; D008055:Lipids; D006710:Homocysteine; D003404:Creatinine; D015248:Gemfibrozil; D011345:Fenofibrate