Related Experiment Videos
[Effect of ciprofibrate on the endothelial dysfunction of patients with combined dyslipidemia]
Insights
Dyslipidemia alone can impair endothelial function, measurable by flow-mediated dilation (FMD). Fibrate treatment improved FMD and lipid levels, suggesting both lipid and non-lipid factors contribute to endothelial dysfunction.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Metabolic Disorders
Context:
- Endothelial dysfunction is an early marker of atherosclerosis.
- The impact of isolated dyslipidemia on endothelial function remains unclear.
- The efficacy of fibrates in improving endothelial function requires further investigation.
Purpose:
- To investigate if dyslipidemia alone harms endothelial function.
- To determine if fibrate therapy can improve endothelial function in dyslipidemic patients.
- To explore the relationship between lipid levels, fibrinogen, and endothelial function.
Summary:
- 84% of patients with isolated combined dyslipidemia exhibited endothelial dysfunction (low flow-mediated dilation - FMD).
- Ciprofibrate treatment (4 weeks) significantly improved FMD, reduced total cholesterol, triglycerides, and fibrinogen, while increasing HDL cholesterol.
- Improved FMD correlated with decreased total cholesterol; cessation of ciprofibrate led to FMD impairment and reversal of lipid/fibrinogen changes.
Impact:
- Dyslipidemia, potentially involving non-lipid factors, contributes to early endothelial dysfunction.
- Fibrate therapy demonstrates potential for improving vascular endothelial function in dyslipidemic individuals.
- This study highlights the complex interplay of lipid and non-lipid factors in early atherosclerosis.
Abstract:
Endothelial dysfunction can be detected in the early phase of atherosclerosis. Two unresolved questions have been raised the wether, (1) the dyslipidemic state alone without any other risk factors can be harmful for the endothelial function measured by ultrasound, and (2) the use of the antilipidemic fibrate is sufficient to influence the endothelial functions. From 38 subjects with solitary combined dyslipidaemia 32 (84%) showed endothelial dysfunction measured by flow mediated vasodilatation (FMD) on the forearm and this group of patients was featured only by higher fibrinogen levels (no differences on BMI, serum lipid and glucose level). The patients with endothelial dysfunction were treated with 100 mg of ciprofibrate per day (12 women, 20 men, average age: 44.6 +/- 9 years, BMI 24.6 +/- 3.4 kg/m2). The pretreatment serum lipid levels were: total cholesterol 6.9 +/- 0.4, triglyceride 4.2 +/- 0.3, HDL cholesterol 1.13 +/- 0.21 mmol/l. After the 4 weeks treatment period the cholesterol and triglyceride level decreased, the concentration of HDL cholesterol increased significantly, which changes were in correspondence with significant improvement of FMD (3.9 +/- 0.7% vs. 7.0 +/- 1.6%). The level of fibrinogen also declined significantly. At the 8th week there were no significant further changes compared to the data received at the 4th week. Using the lineal regressive analysis the improved vasodilatator respond at both check points was correlated only with the fall of total cholesterol level. The ciprofibrate was suspended after the 8th week for a 4 weeks period and the triglyceride and the fibrinogen levels increased whereas the HDL cholesterol level decreased significantly. The FMD impaired significantly (to 5.8 +/- 1.2%). There were no correlations among the changes. The results demonstrated the lipid and probably non-lipid-factors are important in these early damages of endothelial functions.