title: A review of paradoxical HDL-C responses to fenofibrate, illustrated by a case report.
abstract: High-density lipoprotein cholesterol (HDL-C) concentration is an independent risk factor for cardiovascular disease. Fibrates are widely used in the management of atherogenic dyslipidemia, principally for their triglyceride-lowering and HDL-C-raising effects. Fibrates may cause paradoxical reductions in HDL-C. These reductions are usually modest, but significant reductions have been observed. The molecular mechanism for these paradoxical reductions remains unexplained despite advances in our understanding of lipid metabolism. This review considers possible mechanisms for this effect, illustrated by a patient with an observed reduction in HDL-C of 88% after introduction of fenofibrate.
authors.affiliation: Cardiovascular Trials Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK; Cardiovascular Research Group, Core Technology Facility, University of Manchester, Manchester, UK.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Schofield
authors.affiliation: Cardiovascular Research Group, Core Technology Facility, University of Manchester, Manchester, UK.
authors.forename: Yifen
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Cardiovascular Trials Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK; Department of Clinical Biochemistry, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
authors.forename: Michael W
authors.initials: MW
authors.lastname: France
authors.affiliation: Department of Chemical Pathology, Trafford General Hospital, Manchester, UK.
authors.forename: Lance
authors.initials: L
authors.lastname: Sandle
authors.affiliation: Cardiovascular Trials Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK; Cardiovascular Research Group, Core Technology Facility, University of Manchester, Manchester, UK. Electronic address: hsoran@aol.com.
authors.forename: Handrean
authors.initials: H
authors.lastname: Soran
mesh_terms: D017311:Amlodipine / Q000008:administration & dosage; D000069059:Atorvastatin; D008076:Cholesterol, HDL / Q000378:metabolism; D004347:Drug Interactions; D050171:Dyslipidemias / Q000188:drug therapy*; D005260:Female; D011345:Fenofibrate / Q000008:administration & dosage* / Q000009:adverse effects; D006538:Heptanoic Acids / Q000008:administration & dosage; D006801:Humans; D064747:Lansoprazole / Q000008:administration & dosage; D050356:Lipid Metabolism / Q000187:drug effects; D008875:Middle Aged; D009582:Nitrofurantoin / Q000008:administration & dosage; D011758:Pyrroles / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D008076:Cholesterol, HDL; D006538:Heptanoic Acids; D011758:Pyrroles; D064747:Lansoprazole; D017311:Amlodipine; D009582:Nitrofurantoin; D000069059:Atorvastatin; D011345:Fenofibrate
keywords: Fenofibrate; HDL; High-density lipoprotein; High-density lipoprotein cholesterol; Paradoxical reduction in high-density lipoprotein cholesterol