Monocyte-Suppressing Effect of Bezafibrate but not Omega-3 Fatty Acids in Patients with Isolated Hypertriglyceridaemia.

摘要

Fibrates and omega-3 fatty acids have been used for many years in the treatment of increased triglyceride levels. Unfortunately, pleiotropic effects of these agents in patients with isolated hypertriglyceridaemia are poorly understood. The aim of this study was to compare the effect of bezafibrate and omega-3 fatty acids on monocyte cytokine release and systemic inflammation in this type of dyslipidaemia. The study included eighty-seven hypertriglyceridaemic subjects randomly allocated to one of three groups, treated respectively with bezafibrate (200 mg twice daily), omega-3 fatty acids (1 g twice daily) or placebo for 90 days. Eighty-three subjects completed the study. Apart from improvement in lipid profile, bezafibrate treatment reduced plasma high-sensitivity C-reactive protein (hsCRP) levels and inhibited monocyte release of interleukin-6, interleukin-1beta, monocyte chemoattractant protein-1 and tumour necrosis factor-alpha. Bezafibrate action on plasma hsCRP and monocyte cytokine release was lipid-independent but correlated with drug-induced improvement in insulin sensitivity. Omega-3 fatty acids reduced plasma triglycerides, but did not induce any significant changes in monocyte secretory function and plasma hsCRP. Our study suggests that bezafibrate is superior to omega-3 fatty acids in reducing systemic inflammation and in producing monocyte-suppressing effects. Anti-inflammatory actions of bezafibrate may contribute to the clinical effectiveness of fibrates in the prevention and treatment of isolated hypertriglyceridaemia.