title: Fenofibrate reduces inflammation in obese patients with or without type 2 diabetes mellitus via sirtuin 1/fetuin A axis.
abstract: OBJECTIVE
  The aim of the current study is to investigate the effect of fenofibrate alone and in combination with pioglitazone on serum sirtuin 1 and fetuin A of obese patients with Type 2 Diabetes Mellitus (T2DM).
  
  
  METHODS
  Intervention effect on inflammatory parameters was assessed before and after treatment. The study was conducted on 60 postmenopausal females of whom, only 44 patients completed the study. They were distributed as follows; obese patients without T2DM (n=15) who administered fenofibrate (160 mg/day) once for 8 weeks, obese patients with T2DM (n=15) who administered fenofibrate (160 mg/day) once for 8 weeks, obese patients with T2DM (n=14) who administered fenofibrate (160 mg/day) and pioglitazone (15 mg/day) combination once for 8 weeks. We measured fasting plasma glucose, glycated hemoglobin (HbA1c), serum lipids. Inflammatory markers (high sensitivity C-reactive protein "hs-CRP", interleukin-6 "IL-6", fetuin A, and sirtuin 1) of patients were measured in serum using enzyme-linked immunoassay (ELISA) kits.
  
  
  RESULTS
  Sirtuin 1 levels in obese patients with T2DM were significantly lower than its levels in obese patients while fetuin A levels were significantly higher (P<0.001). Fenofibrate, alone and in combination with pioglitazone, significantly decreased triacylglycerol, hs-CRP, IL-6, fetuin A and increased sirtuin 1 levels (P<0.001) which suggests that it can be used to delay the complications of obesity and T2DM. There is a strong correlation between fetuin A, sirtuin 1, IL-6 and hs-CRP levels suggesting a shared common pathway.
  
  
  CONCLUSIONS
  Fenofibrate was shown to increase serum sirtuin 1 and decrease serum fetuin A levels in obese patients.
  
  
  BACKGROUND
  PACTR201407000856135.
authors.affiliation: BSc of Pharmaceutical Sciences, Teaching Assistant at Biochemistry Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt.
authors.forename: Mohamed H
authors.initials: MH
authors.lastname: Noureldein
authors.affiliation: Lecturer of Biochemistry, Biochemistry Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt.
authors.forename: Rania S
authors.initials: RS
authors.lastname: Abd El-Razek
authors.affiliation: Professor of endocrinology and Dean of the National Institute of Diabetes and Endocrinology (NIDE), Cairo, Egypt.
authors.forename: Mohamed H
authors.initials: MH
authors.lastname: El-Hefnawy
authors.affiliation: Professor of Biochemistry and Vice Dean of Postgraduate and Research Affairs, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt. Electronic address: hala.elmesallamy@hotmail.com.
authors.forename: Hala O
authors.initials: HO
authors.lastname: El-Mesallamy
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D011345:Fenofibrate / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D000077205:Pioglitazone; D015398:Signal Transduction / Q000502:physiology; D056564:Sirtuin 1 / Q000378:metabolism*; D045162:Thiazolidinediones / Q000008:administration & dosage; D060749:alpha-2-HS-Glycoprotein / Q000378:metabolism*
chemical_list: D008055:Lipids; D045162:Thiazolidinediones; D060749:alpha-2-HS-Glycoprotein; D002097:C-Reactive Protein; D056564:Sirtuin 1; D011345:Fenofibrate; D000077205:Pioglitazone
keywords: Fenofibrate; Fetuin A; Obesity; Pioglitazone; Sirtuin 1; T2DM