Folate co-administration improves the effectiveness of fenofibrate to decrease the lipoprotein oxidation and endothelial dysfunction surrogates.
Fibrate therapy results in elevation of plasma total homocysteine (tHcy), which is known to induce oxidative stress and endothelial dysfunction. We aimed to establish whether fibrate-induced elevation of tHcy has also similar consequences and whether they may be prevented by folate co-administration. Eighteen subjects with hypercholesterolemia were included in an open, prospective, cross-over study. We compared intra-individually the effect of fenofibrate on tHcy, oxidative stress and endothelial dysfunction surrogates, in monotherapy and when combined with 10 mg of folate. These effects were also compared with fluvastatin monotherapy. Fenofibrate in monotherapy significantly decreased LDL cholesterol, increased the tHcy by 39.5 %, while oxidized LDL (oxLDL), malondialdehyde (MDA), von Willebrand factors (vWf) and thrombomodulin (TMD) remained unchanged. When fibrate was co-administered with folate, the tHcy remained on the initial post-diet level, while both the total and oxLDL as well as MDA, vWf and TMD decreased. In contrast to fenofibrate monotherapy, fluvastatin (80 mg) had a similar effect as combined therapy with fenofibrate and folate, while tHcy remained uninfluenced. In conclusion, fenofibrate decreases the LDL cholesterol, but in contrast to fluvastatin, has no significant antioxidative and endothelium-protective potential, probably due to a concomitant increase of tHcy. These effects may be improved by co-administration of folate.
Mayer
O
O
Second Department of Internal Medicine, Charles University, Plzen, Czech Republic. mayerjr@lfp.cuni.cz
Simon
J
J
Holubec
L
L
Pikner
R
R
Trefil
L
L
D000328:Adult; D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood / Q000187:drug effects; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects; D018592:Cross-Over Studies; D004359:Drug Therapy, Combination; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology; D005229:Fatty Acids, Monounsaturated / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D011345:Fenofibrate / Q000008:administration & dosage / Q000627:therapeutic use*; D000077340:Fluvastatin; D005492:Folic Acid / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D006710:Homocysteine / Q000097:blood; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007211:Indoles / Q000008:administration & dosage / Q000627:therapeutic use; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D011446:Prospective Studies; D018180:Thrombomodulin / Q000097:blood; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D014803:Vitamin B Complex / Q000008:administration & dosage / Q000627:therapeutic use; D014841:von Willebrand Factor / Q000032:analysis
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D005229:Fatty Acids, Monounsaturated; D000960:Hypolipidemic Agents; D007211:Indoles; D008077:Lipoproteins, LDL; D018180:Thrombomodulin; D014280:Triglycerides; C099252:oxidized low density lipoprotein; D014841:von Willebrand Factor; D006710:Homocysteine; D014803:Vitamin B Complex; D000077340:Fluvastatin; D008315:Malondialdehyde; D005492:Folic Acid; D011345:Fenofibrate