Long-Term Effects of Fenofibrate on Carotid Intima-Media Thickness and Augmentation Index in Subjects With Type 2 Diabetes Mellitus

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• 作者：Anne Hiukka ; Jukka Westerbacka ; Eeva S. Leinonen ; Hiroshi Watanabe ; Olov Wiklund ; Lillemor Mattson Hulten ; Jukka T. Salonen ; Tomi-Pekka Tuomainen ; Hannele Yki-Jä ; rvinen ; Anthony C. Keech ; Marja-Riitta Taskinen
• 关键词：type 2 diabetes ; fenofibrate ; intima-media thickness ; augmentation index ; inflammation
• 刊名：Journal of the American College of Cardiology
• 出版年：2008
• 出版时间：16 December 2008-23 December 2008
• 年：2008
• 卷：52
• 期：25
• 页码：2190-2197
• 全文大小：299 K

文摘

Objectives

The aim of this substudy was to ascertain whether long-term treatment with fenofibrate reduces surrogate measures of atherosclerosis, biomarkers of inflammation, and endothelial activation in patients with type 2 diabetes.

Background

Some fibrates may decrease cardiovascular events, improve endothelial function, and reduce levels of acute-phase proteins. In the FIELD (Fenofibrate Intervention and Event Lowering in Diabetes) study, fenofibrate failed to decrease the primary end point of coronary events in patients with type 2 diabetes.

Methods

A total of 170 patients with type 2 diabetes of the FIELD Helsinki cohort were randomly assigned to micronized fenofibrate 200 mg/day or placebo in a double-blind design. Carotid intima-media thickness (IMT) and the augmentation index (a measure of large artery stiffness) were measured at baseline and at second- and fifth-year visits. Plasma levels of interleukin (IL)-6, C-reactive protein (CRP), serum amyloid A (SAA), secretory phospholipase A2 IIA (SPLA2), E-selectin, vascular cellular adhesion molecule (VCAM)-1, and intercellular adhesion molecule (CAM)-1 were determined by commercial enzyme-linked immunosorbent assay kits at the same visits.

Results

IMT and the augmentation index increased similarly in both treatment groups during the study. Plasma levels of CRP, IL-6, SPLA2, SAA, VCAM-1, ICAM-1, and E-selectin remained unchanged in both groups.

Conclusions

Fenofibrate treatment was not associated with beneficial changes in IMT, augmentation index, or biomarkers of inflammation and endothelial function. (Fenofibrate Intervention and Event Lowering in Diabetes; NCT00132886)