Different Effects of Fenofibrate on Metabolic and Cardiovascular Risk Factors in Mixed Dyslipidemic Women With Normal Thyroid Function and Subclinical Hypothyroidism

Abstract

SUMMARYAims: Subclinical hypothyroidism is suggested to increase cardiovascular risk. No previous study compared the effect of any fibrate on plasma levels of lipids and other cardiovascular risk factors in patients with different thyroid function status. Methods: The study included three age-, weight-and lipid-matched groups of women with mixed dyslipidemia in different thyroid function status: patients with untreated subclinical hypothyroidism (group 1, n = 18), women with treated hypothyroidism (group 2, n = 15), and subjects without thyroid disorders (group 3, n = 19). Plasma lipids, glucose homeostasis markers, as well as plasma levels of uric acid, high-sensitivity C-reactive protein (hsCRP), homocysteine, and fibrinogen were determined before and after 12 weeks of fenofibrate therapy. Results: Despite similar plasma lipid levels, mixed dyslipidemic patients with untreated hypothyroidism had decreased insulin sensitivity, as well as higher circulating levels of uric acid, hsCRP, homocysteine, and fibrinogen in comparison with the other groups. The effect of fenofibrate on plasma lipids and, with the exception of homocysteine, on circulating levels of all investigated risk factors was stronger in patients from groups 2 and 3 than in patients from group 1. Conclusions: The obtained results indicate that the effect of fenofibrate on plasma lipids and circulating levels of cardiovascular risk factors is partially related to thyroid function. They also suggest that to improve the strength of fibrate action in dyslipidemic patients with subclinical hypothyroidism, they should be administered together with L-thyroxine.

The Effect of Testosterone and Fenofibrate, Administered Alone or in Combination, on Cardiometabolic Risk Factors in Men with Late‐Onset Hypogonadism and Atherogenic Dyslipidemia

“…Previously, we observed a multidirectional action of fenofibrate including an improvement in glucose metabolism and the inhibitory action on plasma lipids and other risk factors in various metabolic disturbances, including prediabetes, overt diabetes, and mixed dyslipidemia [20][21][22][23][24]. However, the present study is the first which has shown a beneficial effect of any fibrate in patients with hypogonadism.…”

Different cardiometabolic effects of atorvastatin in men with normal vitamin D status and vitamin D insufficiency

“…Recently, we have found that the effect of atorvastatin as well as fenofibrate, which is another lipid‐lowering drug with pleiotropic effects, on plasma lipids and circulating levels of cardiometabolic risk factors partially depended on hypothalamic‐pituitary‐thyroid axis activity and was more pronounced in patients with normal thyroid function than in patients with untreated subclinical hypothyroidism. A possible association between vitamin D and vascular disease suggests that the effects of hypolipidemic agents may also be determined by the amount of this vitamin.…”

Wpływ leczenia hipolipemicznego na wydzielanie cytokin prozapalnych w różnych grupach wiekowych pacjentów z cukrzycą typu 2 i dyslipidemią aterogenną

“…Despite these obvious benefits, statin therapy seems to be associated with a slightly increased risk of development of diabetes [13,14]. An improvement in glucose homeostasis was, in turn, induced by peroxisome proliferator-activated receptor-a (PPARa) activators (fibrates) [15][16][17][18], but the favourable effect of this group of hypolipidaemic agents on cardiovascular morbidity and mortality was observed only in some studies [19,20]. Moreover, no large clinical study has investigated the relationship between age and clinical effectiveness of PPARa activators or included only older adults.…”