Comparison of Effects of Atorvastatin and Fenofibrate on Plasma Homocysteine, Folic Acid and Vitamin B12 Levels in Patients With Mixed Hyperlipidemia

摘要

Summary Objectives: Hyperhomocysteinemia is an independent cardiovascular risk factor. Lipid lowering agents such as fenofibrate have been reported to elevate plasma homocysteine levels. Atorvastatin is another kind of lipid lowering agent and there is not enough study investigating its effects on plasma homocysteine. In the present study we aimed to compare the effects of atorvastatin and fenofibrate on plasma homocysteine, folic acid and vitamin B12 levels.Materials and Methods: Total of 43 patients were randomized into one of 2 groups: One of them (n=20) treated with atorvastatin, other (n=23) with fenofibrate for 3 months. After 1 and 3 months of treatment with these drugs, blood samples were collected and plasma lipids, folic acid, vitamin B12 and homocysteine levels were determined.Results: Both of the lipid lowering agents significantly decreased plasma lipid levels. Atorvastatin group showed a significant reduction in total cholesterol and LDL-C than those in fenofibrate group. On the other hand, fenofibrate caused a greater reduction in triglyceride levels compared to the atorvastatin. There was no change in plasma folic acid and vitamin B12 levels after treatment with both of these hypolipidemic drugs. There was a significant increase in homocysteine levels after treatment with fenofibrate and atorvastatin, although fenofibrate was more effective than atorvastatin (36 and 15% respectively).Conclusions: We conclude that increases in plasma homocysteine levels are a result of the known impairment of renal function caused by fenofibrate and a result of impairment of liver function caused by atorvastatin.?2006, Fırat üniversitesi, Tıp Fakültesi Top