Pleiotropic effects of atorvastatin and fenofibrate in metabolic syndrome and different types of pre-diabetes.
OBJECTIVE
To compare extra-lipid effects of statins and fibrates in relation to the baseline metabolic status of patients.


METHODS
The study involved a group of 242 metabolic syndrome patients with or without pre-diabetes and randomized to atorvastatin, fenofibrate, or placebo.


RESULTS
Compared with matched healthy subjects, metabolic syndrome patients exhibited higher plasma levels/activities of high-sensitivity C-reactive protein (hs-CRP), fibrinogen, factor VII, plasminogen activator inhibitor 1, and enhanced monocyte cytokine release. These abnormalities were alleviated by both atorvastatin and fenofibrate treatment. CRP-lowering and monocyte-suppressing actions were more pronounced for atorvastatin in subjects with impaired fasting glucose and for fenofibrate in patients with impaired glucose tolerance.


CONCLUSIONS
The presence of pre-diabetes potentiates metabolic syndrome-induced abnormalities in plasma markers of inflammation and hemostasis and in monocyte secretory function. Both atorvastatin and fenofibrate exhibit multidirectional pleiotropic effects in subjects with metabolic syndrome, the strength of which seem to be partially determined by the type of pre-diabetes.
Krysiak
Robert
R
Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland. r.krysiak@interia.pl
Gdula-Dymek
Anna
A
Bachowski
Ryszard
R
Okopien
Boguslaw
B
D000924:Anticholesteremic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000069059:Atorvastatin; D002097:C-Reactive Protein / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism; D005167:Factor VII / Q000378:metabolism; D011345:Fenofibrate / Q000009:adverse effects* / Q000627:therapeutic use; D005340:Fibrinogen / Q000378:metabolism; D006538:Heptanoic Acids / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D024821:Metabolic Syndrome / Q000188:drug therapy* / Q000378:metabolism; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism; D011236:Prediabetic State / Q000139:chemically induced* / Q000378:metabolism; D011758:Pyrroles / Q000009:adverse effects* / Q000627:therapeutic use
D000924:Anticholesteremic Agents; D016207:Cytokines; D006538:Heptanoic Acids; D017395:Plasminogen Activator Inhibitor 1; D011758:Pyrroles; D005167:Factor VII; D005340:Fibrinogen; D002097:C-Reactive Protein; D000069059:Atorvastatin; D011345:Fenofibrate