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17 March 2003

Effects of hypolipidemic treatment on serum markers of vascular inflammation in dyslipidemic men.

Cristina Hernandez, Albert Lecube, Gloria Barberá, Pilar Chacón, Joan Lima, Rafael Simó

Med Sci Monit 2003; 9(3): CR114-119 :: ID: 4731

Abstract

BACKGROUND: The purpose of our study was to assess the effect of hypolipidemiant drugs on serum markers of vascular inflammation (E-Selectin, VCAM-1 and MCP-1) in dyslipidemic men without cardiovascular disease. MATERIAL/METHODS: 84 dyslipidemic men were consecutively recruited from the Lipid Unit of a tertiary hospital. The patients were placed on statins (n=44) or fibrates (n=22), depending on the lipid profile, for 4 months. In the control group (n=18), a hypolipidemiant diet alone was indicated. RESULTS: Baseline levels of VCAM-1 and MCP-1 were not correlated with the lipid profile. By contrast, baseline E-Selectin levels correlated directly with glucose and triglyceride levels, and negatively with HDL-C. In multiple regression analysis, HDL-C and glucose concentrations independently influenced E-selectin levels. After treatment, we observed a significant decrease of E-Selectin levels in patients treated with statins, and the changes in E-Selectin levels were inversely associated with HDL-C variations. We did not observe any changes in VCAM-1 levels after the treatment regime we used. Regarding MCP-1, a significant increase was detected in the patients receiving fibrates. In addition, the percentage increment of MCP-1 was higher in patients treated with gemfibrozil than in patients who received bezafibrate. CONCLUSIONS: We observed a reduction in E-Selectin levels after statin therapy. This finding was associated with increased HDL-C. Fibrates, especially gemfibrozil, increased MCP-1 concentrations. This deleterious effect was unrelated to changes in lipid profile, and may help explain why fibrates have less impact than statins in reducing cardiovascular disease.

Keywords: Bezafibrate - therapeutic use, Chemokine CCL2 - blood, Gemfibrozil - therapeutic use, Hyperlipoproteinemia Type II - blood, Hyperlipoproteinemia Type II - drug therapy, Hyperlipoproteinemia Type IV - drug therapy, Lovastatin - therapeutic use, Vascular Cell Adhesion Molecule-1 - blood

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750