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Published on: March 28, 2013

PPAR-alpha: therapeutic role in diabetes-related cardiovascular disease

Alice Y Y Cheng1, Lawrence A Leiter

  • 1Division of Endocrinology and Metabolism, St Michael's Hospital, Toronto, Ontario, Canada.

Diabetes, Obesity & Metabolism
|June 27, 2007
PubMed

Insights

Fibrates targeting PPAR-alpha do not reduce cardiovascular risk in diabetes patients as monotherapy. Further research is needed to explore their role in combination with statins for managing cardiovascular disease in this population.

Area of Science:

  • Endocrinology
  • Cardiology
  • Pharmacology

Background:

  • Cardiovascular disease is the leading cause of death in diabetes mellitus patients.
  • Peroxisome proliferator-activated receptors (PPARs), particularly PPAR-alpha, are involved in glucose/lipid metabolism and atherosclerosis.
  • Fibrates, PPAR-alpha agonists, are used to treat dyslipidemia often seen in diabetes.

Purpose of the Study:

  • To evaluate the efficacy of fibrates in reducing cardiovascular events in patients with diabetes mellitus.
  • To determine the role of fibrates as monotherapy for cardiovascular risk reduction in this population.

Main Methods:

  • Analysis of large prospective clinical trials, including the FIELD study, which exclusively enrolled patients with diabetes.
  • Assessment of cardiovascular endpoints (primary and secondary) in patients treated with fibrates.

Main Results:

  • The FIELD study showed no significant reduction in primary cardiovascular endpoints.
  • Some benefit was observed in secondary endpoints, but overall efficacy as monotherapy was not demonstrated.
  • Previous trials with fibrates included only small subgroups of diabetic patients.

Conclusions:

  • Currently, fibrates lack a defined role as monotherapy for reducing cardiovascular risk in individuals with diabetes mellitus.
  • The potential benefit of fibrates in combination with statin therapy requires further investigation through ongoing studies.

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