The effect of fenofibrate on serum paraoxonase activity and inflammatory markers in patients with combined hyperlipidemia

BACKGROUND: Lipid lowering therapy with statins is beneficial because of improvement in lipoprotein concentrations and additional pleiotropic effects. However, less is known about the pleotropic effect of fibrates. AIM: To investigate the effects of fenofibrate therapy on inflammatory markers and serum paraoxonase activity in patients with combined hyperlipidemia in addition to their lipid lowering effects. METHODS: Fifty patients (18 women, 32 men, mean age 50+/-8.7 years) with a history of combined hyperlipidemia and coronary artery disease were enrolled into the study. Serum lipids, inflammatory markers (high sensitivity C-reactive protein (hs-CRP) and fibrinogen levels) and paraoxonase levels were determined before and after two months of 250 mg per day of fenofibrate treatment. RESULTS: Fenofibrate decreased plasma fibrinogen level by 41% (from 3.9+/-0.9 mg/dl to 2.3+/-0.48 mg/dl, p<0.0001) and hs-CRP level by 71% (from 1.28 mg/dl to 0.36 mg/dl; p<0.0001). Changes in hs-CRP levels were not correlated with the changes in lipid levels. Compared with baseline, serum paraoxonase level was significantly increased after fenofibrate treatment (from 200+/-77U/L to 232+/-82U/L; p<0.001). We found a significant correlation between changes in HDL cholesterol and paraoxonase activity after two months of treatment (r=0.46, p=0.018). CONCLUSION: This study demonstrates that beyond improving lipids and lipoprotein levels, fenofibrate treatment increases paraoxonase activity and decreases inflammatory markers in patients with combined hyperlipidemia.