The effect of ciprofibrate on flow-mediated dilation and inflammatory markers in patients with combined
Imre Kovács1, Erzsébet Toldy, Tatjana Abel
13rd Department of Medicine, Markusovszky Hospital, Szombathely, Hungary.
Insights
In patients with combined hyperlipidemia, improving flow-mediated dilation (FMD) is linked to reduced cholesterol and triglyceride levels. Ciprofibrate treatment significantly improved FMD, correlating with cholesterol reduction.
Area of Science:
- Cardiovascular Research
- Endocrinology
- Vascular Biology
Background:
- Impaired flow-mediated dilation (FMD) is linked to hypercholesterolemia and hypertriglyceridemia.
- The impact of inflammatory markers on endothelial function in hyperlipidemia needs further investigation.
Purpose of the Study:
- To investigate the effect of diet and ciprofibrate on FMD in patients with combined hyperlipidemia.
- To clarify the relationship between changes in inflammatory markers, lipid levels, and FMD.
Main Methods:
- Randomized controlled trial involving 29 patients with combined hyperlipidemia.
- Patients were assigned to a diet-only or ciprofibrate treatment group for 8 weeks.
- Measurements included FMD, lipid profiles, and inflammatory markers (IL-1α, TNFα, sICAM, fibrinogen).
Main Results:
- Both diet and ciprofibrate significantly improved FMD.
- Ciprofibrate therapy led to a greater FMD improvement (79.4%) compared to diet alone (10.2%).
- FMD improvement correlated with reductions in cholesterol and triglyceride levels, particularly cholesterol with ciprofibrate.
Conclusions:
- Improvement in FMD in hyperlipidemic patients is primarily associated with reductions in cholesterol and triglyceride levels.
- While ciprofibrate reduced inflammatory markers, the direct link to FMD improvement was less pronounced than lipid reduction.
- These findings underscore the importance of lipid management for vascular endothelial function.
Abstract:
Impairment of flow-mediated dilation (FMD) has been shown to be associated with hypercholesterolemia and hypertriglyceridemia and reduction of cholesterol and/or triglyceride levels can improve FMD. In hyperlipidemia the role of inflammatory substances on endothelial function requires further clarification. In patients with combined hyperlipidemia (n = 29), the capacity of FMD was weaker whereas the levels of interleukin (IL)-lalpha, tumor necrosis factor alpha (TNFalpha), soluble intercellular adhesion molecule (sICAM), and fibrinogen were higher compared to normolipemic controls with normal FMD adjusted for age and sex. Patients were randomized to a diet-only or to a ciprofibrate treatment group. After 8 weeks FMD levels rose significantly both in the diet-only (10.2%) and the ciprofibrate treatment (79.4%) groups. In the diet-only group improvement of FMD was significantly associated with the reduction of triglyceride (by 15.9%) and cholesterol (6.9%) levels. The much larger improvement of FMD due to ciprofibrate therapy was accompanied by significant reductions of cholesterol (by 14.4%), fibrinogen, IL-1alpha, and sICAM levels and by significant increase of high-density lipoprotein (HDL) cholesterol concentration, but the change in FMD correlated only with the reduction of the cholesterol level. In line with previous data the authors emphasize that improvement of FMD in patients with combined hyperlipidemia treated with diet and/or ciprofibrate is linked directly to the reduction of cholesterol and triglyceride concentrations rather than to changes in the level of the investigated inflammatory markers.
