The effect of fenofibrate on lymphocyte release of proinflammatory cytokines and systemic inflammation in simvastatin-treated patients with atherosclerosis and early glucose metabolism disturbances.

This study was designed to investigate whether fibrates produce lymphocyte-suppressing and systemic anti-inflammatory effects in statin-treated pre-diabetic patients. The study included 47 atherosclerotic patients with the concomitant presence of impaired fasting glucose and impaired glucose tolerance already receiving simvastatin treatment (40 mg daily) who were allocated to one of two groups treated for 90 days with, respectively, fenofibrate (200 mg daily) or placebo. Plasma lipids, glucose homoeostasis markers, plasma high-sensitivity C-reactive protein as well as lymphocyte release of pro-inflammatory cytokines were determined on the allocation day and after 90 days of therapy. Compared with placebo, fenofibrate reduced lymphocyte release of interleukin-2, interferon-γ and tumour necrosis factor-α, which was accompanied by a reduction in plasma C-reactive protein levels. The results obtained indicate that fenofibrate inhibits lymphocyte secretory function and reduces low-grade inflammation in patients with both impaired fasting glucose and impaired glucose tolerance. Our findings suggest that the combined treatment with simvastatin and fenofibrate may be a better treatment option than simvastatin alone in this group of patients, particularly in those who are at high risk for cardiovascular events.