Fibrates plus betaine: a winning combination?
Because most of the cardiac risk remains despite successful statin therapy there has been renewed interest in fibrate therapy for persisting hyperlipidaemia. Fibrate therapy lowers triglycerides but causes the urinary loss of betaine, which is an essential metabolite that is involved in osmoregulation, in methyl group metabolism, and which also affects lipid partitioning in the body. Loss of betaine is associated with an elevation of homocysteine and may compromise the potential benefits of fibrate therapy. However, betaine deficiency could be easily and inexpensively corrected by concurrent betaine supplementation. Clinical trials of combinations of betaine and fibrate, to complement statin therapy, are needed to determine the value of these agents in reducing the residual cardiovascular disease risk.
Lever
Michael
M
Biochemistry Unit, Canterbury Health Laboratories, Christchurch, New Zealand. michael.lever@otago.ac.nz
George
Peter M
PM
Slow
Sandy
S
Elmslie
Jane L
JL
Shand
Brett I
BI
Scott
Russell S
RS
Chambers
Stephen T
ST
D001622:Betaine / Q000627:therapeutic use*; D002995:Clofibric Acid / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy* / Q000378:metabolism; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008082:Lipotropic Agents / Q000627:therapeutic use*; D016896:Treatment Outcome
D000960:Hypolipidemic Agents; D008082:Lipotropic Agents; D001622:Betaine; D002995:Clofibric Acid