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The effect of treatment with fenofibrate on the risk profile of patients with metabolic syndrome and mixed dyslipidemia treated on an outpatient basis


Authors: H. Rosolová 1;  Členové Českého Institutu Metabolického Syndromu (v Abecedním Pořadí): V. Bláha 2;  R. Češka 3;  Z. Hamouz 4;  T. Pelikánová 5;  V. Soška 6;  M. Souček 7;  P. Sucharda 3
Authors‘ workplace: II. interní klinika Lékařské fakulty UK a FN Plzeň, přednosta doc. MUDr. Jan Filipovský, CSc. 1;  Klinika gerontologická a metabolická Lékařské fakulty UK a FN Hradec Králové, přednosta prof. MUDr. Luboš Sobotka, CSc. 2;  III. interní klinika 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Štěpán Svačina, DrSc., MBA 3;  Ordinace praktického lékaře Chomutov 4;  Diabetologické centrum IKEM Praha, přednostka prof. MUDr. Terezie Pelikánová, DrSc. 5;  Oddělení klinické biochemie FN u sv. Anny Brno, přednosta doc. MUDr. Vladimír Soška, CSc. 6;  II. interní klinika Lékařské fakulty MU a FN u sv. Anny Brno, přednosta doc. MUDr. Miroslav Souček, CSc. 7
Published in: Vnitř Lék 2007; 53(4): 339-346
Category: Original Contributions

Overview

The study has shown that patients with metabolic syndrome and typical dyslipidemia treated on an outpatient basis by general practitioners or specialists are those whose anamneses include IHD or diabetes and who are very often indicated for combined statin-fibrate therapy. Fenofibrate therapy combined with a single lifestyle intervention in the form of individual interview resulted in the following improvement of the risk profile of the above patients: significant decrease in body weight and waist circumference, decrease in blood pressure and fasting glycemia; improvement of typical dyslipidemia in 90 % of patients, however, only 30 % of patients achieved the target TG levels below 1.7 mmol/l and the HDL-cholesterol levels above 1.3 mmol/l and 1 mmol/l in women and men, respectively. A total of 60 % of patients no longer met the criteria for MS after 6 months of therapy. However, LDL-cholesterol and total cholesterol levels in patients with IHD or with diabetes were very unsatisfactory; only 6 % of patients had achieved the recommended level of target LDL-cholesterol below 2.5 mmol/l before the intervention, i.e. 94 % of the patient sample was indicated for statin therapy. 86 % of patients with LDL-cholesterol above 2.5 mmol/l remained in our patient sample after non-pharmacological and pharmacological fibrate therapy. The results show that combined statin – fibrate therapy would be the best therapy for patients with IHD or diabetes who meet the MS criteria and whose typical dyslipidemia is expressed.

Key words:
dyslipidemia – fenofibrate – metabolic syndrome


Sources

1. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001; 285: 2486-2497.

2. Rubins HB, Robins SJ, Collins D et al. Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high density lipoprotein cholesterol. N Engl J Cardiol 1999; 241: 410-418.

3. Must A, Spadamo J, Coakley EH et al. The disease burden associated with overweight and obesity. JAMA 1999; 282: 1523-1529.

4. Adherence to long-term therapies: evidence for action. World Health Organization 2003, 211.

5. Mancia G, Pessina AC, Trimarco B et al. on behalf of the SILVIA Study Group: Blood pressure control according to new guidelines targets in low- to high-risk hypertensives managed in specialist practice. J Hypertens 2004; 22: 2387-2396.

6. Cífková R, Býma S, Češka R et al. Prevence kardiovaskulárních onemocnění v dospělém věku. Společné doporučení českých odborných společností. Vnitř Lék 2005; 51: 1021-1036.

7. Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of cholesterol-lowering with simvastatin in 5963 people with diabetes: A randomised placebo-controlled trial. Lancet 2003; 361: 2005-2016.

8. Grundy SM, Vega GL, Juan Z et al. Effectiveness and tolerability of Simvastatin plus Fenofibrate for combined hyperlipidemia (The SAFARI Trial). Am J Cardiol 2005; 95: 462-468.

Labels
Diabetology Endocrinology Internal medicine

Article was published in

Internal Medicine

Issue 4

2007 Issue 4

Most read in this issue
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