[Nonlipid effects of fibrates]

Fibrates, agonists of nuclear peroxisome proliferator-activated receptors alpha (PPAR alpha), are useful in treatment of dyslipidaemia via reductions in triglycerides, LDL cholesterol, and increase in HDL cholesterol. Growing evidence indicates that this class of drugs may show some beneficial nonlipid effects in vitro. It has been demonstrated that fibrates affect the synthesis of some proinflammatory and prothrombotic proteins. The main nonlipid effects of fibrates include: improved insulin resistance, impaired synthesis of proinflammatory cytokines (e.g. IL-1 beta, IL-6), C-reactive protein, CD40 ligand and adhesion proteins, enhanced fibrinolysis mainly due to decrease in PAI-1 production, and attenuation of thrombin generation mainly indicated by decreased TF expression. Further studies are required to prove that clinical relevance of these additional effects of fibrates is independent of their beneficial effects on lipid profile.