Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
Basic Clin Pharmacol Toxicol. 2013 Mar;112(3):198-202. doi: 10.1111/bcpt.12003. Epub 2012 Sep 29.
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.
本研究旨在探讨贝特类药物是否在他汀类药物治疗的糖尿病前期患者中产生抑制淋巴细胞和全身抗炎作用。该研究纳入了 47 名动脉粥样硬化患者，这些患者同时存在空腹血糖受损和糖耐量受损，已经接受辛伐他汀治疗（每天 40 毫克），并将其分为两组，分别接受为期 90 天的非诺贝特（每天 200 毫克）或安慰剂治疗。在分配日和治疗 90 天后，测定了患者的血浆脂质、血糖稳态标志物、血浆高敏 C 反应蛋白以及淋巴细胞释放的促炎细胞因子。与安慰剂相比，非诺贝特降低了淋巴细胞释放的白细胞介素-2、干扰素-γ 和肿瘤坏死因子-α，同时降低了血浆 C 反应蛋白水平。研究结果表明，非诺贝特抑制了空腹血糖受损和糖耐量受损患者的淋巴细胞分泌功能，并降低了低度炎症。我们的研究结果表明，在这组患者中，辛伐他汀联合非诺贝特治疗可能优于单独使用辛伐他汀，尤其是在那些发生心血管事件风险较高的患者中。
