PMID- 19199980
OWN - NLM
STAT- MEDLINE
DCOM- 20090420
LR  - 20190728
IS  - 1873-4286 (Electronic)
IS  - 1381-6128 (Linking)
VI  - 15
IP  - 5
DP  - 2009
TI  - Fibrates and microvascular complications in diabetes--insight from the FIELD 
      study.
PG  - 537-52
AB  - Fibrates are widely prescribed lipid-lowering drug in the treatment of 
      dyslipidemia. Their main clinical effects, mediated by peroxisome proliferative 
      activated receptor (PPAR) alpha activation, are a moderate reduction in total 
      cholesterol and low-density lipoprotein cholesterol (LDL-C) levels, a marked 
      reduction in triglycerides (TG) and an increase in high-density lipoprotein 
      cholesterol (HDL-C), usually dependent of their baseline levels and dyslipidemia 
      type. A beneficial effect on cardiovascular outcomes but also on inflammatory and 
      thrombogenesis pathways as well as antioxidant properties have been evidenced 
      conferring other pleiotropic effects to fibrates. Diabetic retinopathy, 
      nephropathy and neuropathy are the major microvascular complications of Type 2 
      diabetes mellitus (T2DM) and their presence can accentuate the risk of 
      cardiovascular disease. Hyperglycemia, hypertension, genetic susceptibility among 
      other risk factors play a significant role in the development and progression of 
      these complications. Plasma lipid abnormalities are also involved in the 
      pathogenesis of microvascular diseases suggesting a potential benefit of lipid 
      lowering drugs in their prevention. Clofibrate was the first fibrate in the 60's 
      to show an improvement in the retinal hard exudation in subjects with diabetic 
      retinopathy. Recently, in the Fenofibrate Intervention in Event Lowering in 
      Diabetes (FIELD) study fenofibrate treatment demonstrated a significant 30% 
      reduction in the need for laser therapy in patients with and without known 
      diabetic retinopathy, and more particularly in the first course of laser 
      treatment for both macular edema and proliferative retinopathy. In addition, 
      fenofibrate treatment was associated with less albuminuria progression and 
      reduced risk of non traumatic distal amputations. These results, along with 
      previous evidence of positive effects on microvascular complications, suggest 
      that fibrates, and particularly fenofibrate, offer good opportunity to prevent 
      the most serious complications of diabetes.
FAU - Ansquer, J C
AU  - Ansquer JC
AD  - Laboratoires Fournier SA, Cardiometabolic Therapeutic Area, Daix, France. 
      jean-claude.ansquer@solvay.com
FAU - Foucher, C
AU  - Foucher C
FAU - Aubonnet, P
AU  - Aubonnet P
FAU - Le Malicot, K
AU  - Le Malicot K
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United Arab Emirates
TA  - Curr Pharm Des
JT  - Current pharmaceutical design
JID - 9602487
RN  - 0 (Hypolipidemic Agents)
RN  - 53PF01Q249 (Clofibric Acid)
RN  - U202363UOS (Fenofibrate)
SB  - IM
MH  - Animals
MH  - Cardiovascular Diseases/etiology/prevention & control
MH  - Clofibric Acid/*pharmacology/therapeutic use
MH  - Diabetes Mellitus, Type 2/complications/*drug therapy
MH  - Diabetic Angiopathies/prevention & control
MH  - Diabetic Nephropathies/prevention & control
MH  - Diabetic Neuropathies/prevention & control
MH  - Fenofibrate/pharmacology/therapeutic use
MH  - Humans
MH  - Hypolipidemic Agents/*pharmacology/therapeutic use
MH  - Randomized Controlled Trials as Topic
MH  - Risk Factors
RF  - 158
EDAT- 2009/02/10 09:00
MHDA- 2009/04/21 09:00
CRDT- 2009/02/10 09:00
PHST- 2009/02/10 09:00 [entrez]
PHST- 2009/02/10 09:00 [pubmed]
PHST- 2009/04/21 09:00 [medline]
AID - 10.2174/138161209787315701 [doi]
PST - ppublish
SO  - Curr Pharm Des. 2009;15(5):537-52. doi: 10.2174/138161209787315701.