VA Medical Center, North Chicago, IL 60064, USA.
Am J Ther. 2010 Nov-Dec;17(6):e182-8. doi: 10.1097/MJT.0b013e3181dcf72b.
Dyslipidemia increases the risk of cardiovascular disease (CVD) risk which is a leading cause of mortality. This creates the need for therapies to effectively manage dyslipidemia to decrease the CVD risk associated with it. This meta-analysis evaluates fibrate therapy in respect to dealing with dyslipidemia and CVD risk. Fibrates significantly reduced plasma total cholesterol by 8% and significantly reduced triglyceride levels by 30%. High density lipoprotein cholesterol levels were raised by 9% with fibrates. All-cause mortality and noncardiovascular mortality were both significantly increased with fibrates but these significant changes no longer appeared after trials using clofibrate were removed from the analysis. There was no significant reduction in fatal myocardial infarction but there was a significant 22% reduction of nonfatal myocardial infarction. Fibrates can effectively reduce low density lipoprotein C (LDL-C) while also optimizing high-density lipoprotein and triglyceride levels as well, which statins do not. Negative effects of fibrates were not significant after clofibrate trials were removed from consideration in the study. It should be noted that gemfibrozil should not be used as well due to its adverse effects.
血脂异常增加了心血管疾病 (CVD) 的风险，这是导致死亡的主要原因之一。因此，需要有治疗方法来有效地控制血脂异常，以降低与之相关的 CVD 风险。本荟萃分析评估了贝特类药物治疗血脂异常和 CVD 风险的效果。贝特类药物可显著降低血浆总胆固醇 8%，显著降低甘油三酯水平 30%。贝特类药物可使高密度脂蛋白胆固醇水平升高 9%。全因死亡率和非心血管死亡率均显著升高，但在剔除氯贝特试验后，这些显著变化在分析中不再出现。致命性心肌梗死无显著减少，但非致死性心肌梗死显著减少 22%。贝特类药物可有效降低低密度脂蛋白胆固醇 (LDL-C)，同时还能优化高密度脂蛋白和甘油三酯水平，而他汀类药物则不能。在剔除氯贝特试验后，贝特类药物的不良反应并不显著。值得注意的是，由于其不良反应，吉非贝齐也不应使用。
