Decrease in inflammatory cardiovascular risk markers in hyperlipidemic diabetic patients treated with fenofibrate.

The goal was to investigate the effect of micronized fenofibrate, a hypolipidemic drug, on inflammatory markers and proinsulin in patients with type 2 diabetes who had hyperlipidemia. Thirty-nine patients were treated with micronized fenofibrate (200 mg/day for 12 wk). Erythrocyte sedimentation rate (ESR), fibrinogen, high-sensitivity C-reactive protein (hs CRP), and proinsulin levels were measured at baseline and after 12 wk of therapy. Micronized fenofibrate significantly reduced serum triglyceride, cholesterol, and uric acid levels (all p <0.0001) and increased high-density lipoprotein (HDL)-cholesterol (p <0.001) and creatinine levels (p <0.0001). Micronized fenofibrate also significantly decreased fibrinogen (421 +/- 152 vs 344 +/- 81 mg/dl, p <0.001), hs-CRP (3.3 +/- 3.3 vs 2.1 +/- 1.8 mg/L, p <0.01), and ESR (19.1 +/- 24.8 vs 9.7 +/- 8.7 mm/hr, p <0.01), but did not change proinsulin levels. The correlations among changes of hs-CRP, fibrinogen, and ESR were high. Although correlation among the decreases in inflammatory markers (ESR, fibrinogen, and hs-CRP) was significant, there was no significant correlation between the changes of lipid profile and inflammatory markers. In conclusion, after 12 wk, micronized fenofibrate therapy significantly decreased 3 inflammatory markers (hs-CRP, ESR, and fibrinogen) and improved the lipid profile by decreasing serum triglyceride, cholesterol, and non-HDL-cholesterol levels and increasing HDL-cholesterol; however, it did not change serum proinsulin level, a pancreatic stress marker.