Fenofibrate may have 'clinically relevant' benefits over omega-3 fatty acids
MedWire News: Omega-3 fatty acids and fenofibrate have comparable effects on endothelial-dependent dilation and triglycerides in hypertriglyceridemia, but fenofibrate has a greater impact on lipoprotein and metabolic profiles, says a team of scientists.
Both fenofibrate and omega-3 fatty acids reduce the likelihood of cardiovascular events, possibly via reductions in endothelial dysfunction. However, there has been no direct comparison of the lipoprotein and metabolic effects of these two treatments.
Kwang Kon Koh, from Gachon University Gil Hospital in Incheon, Republic of Korea, and colleagues therefore conducted a randomized, single-blind, placebo-controlled, parallel study in which a placebo, omega-3 fatty acids 2 g, or fenofibrate 160 mg were given to age-, gender-, and body mass index-matched hypertriglyceridemia patients for 2 months.
There were 50 patients in each of the treatment groups, and a dietician advised patients to maintain a low fat diet, the team reports in the journal Atherosclerosis. The patients were assessed at least every 14 days during the study.
Placebo treatment was associated with significant reductions in triglycerides and the triglyceride/high density lipoprotein (HDL) cholesterol ratio. However, patients receiving placebo had increased low-density lipoprotein (LDL) cholesterol levels and there was no effect on the flow-mediated dilator response to hyperemia, or on insulin or glucose levels.
Triglycerides were reduced by 21% with omega-3 fatty acids, and the treatment was linked to a significant reduction in the triglyceride/HDL cholesterol ratio and an improvement in flow-mediated dilation. However, it had no effect on insulin, plasma adiponectin levels, or insulin sensitivity.
Fenofibrate was linked to a 29% reduction in triglycerides, as well as reductions in total cholesterol and the triglyceride/HDL cholesterol ratio, and improved flow-mediated dilation. It also decreased non-HDL cholesterol levels and the triglyceride/HDL cholesterol ratio, and increased HDL cholesterol and apolipoprotein compared with placebo and omega-3 fatty acids, and decreased fasting insulin and increased plasma adiponectin and insulin sensitivity versus omega-3 fatty acids.
The team concludes: "Omega-3 fatty acids and fenofibrate therapy mediated similar changes in triglycerides and endothelium-dependent dilation, however, each therapy had differential lipoprotein and metabolic effects in patients with hypertriglyceridemia that may be clinically relevant with fenofibrate causing substantial metabolic improvements above and beyond the lipid improvements."
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By Liam Davenport