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Fibrates plus betaine: a winning combination?
Michael Lever1, Peter M George, Sandy Slow
1Biochemistry Unit, Canterbury Health Laboratories, Christchurch, New Zealand. michael.lever@otago.ac.nz
The New Zealand Medical Journal
|October 19, 2010
Summary
Fibrate therapy may help persistent high cholesterol but can deplete betaine, increasing homocysteine. Combining fibrates with betaine supplements could mitigate risks and improve cardiovascular outcomes.
Area of Science:
- Cardiovascular Medicine
- Metabolic Disorders
- Pharmacology
Background:
- Residual cardiovascular risk persists despite statin therapy.
- Fibrates are considered for hyperlipidemia but have side effects.
- Fibrates lower triglycerides but cause urinary betaine loss.
Purpose of the Study:
- To investigate the role of betaine in mitigating fibrate therapy side effects.
- To explore the potential of combined betaine and fibrate therapy for cardiovascular risk reduction.
Main Methods:
- Review of metabolic pathways involving betaine.
- Analysis of the association between betaine loss and homocysteine elevation.
- Discussion of potential clinical trial designs for combined therapy.
Main Results:
- Betaine is crucial for osmoregulation, methyl metabolism, and lipid partitioning.
- Urinary betaine loss during fibrate therapy is linked to homocysteine increase.
- Betaine deficiency is correctable with concurrent supplementation.
Conclusions:
- Concurrent betaine supplementation may offset adverse effects of fibrate therapy.
- Clinical trials are needed to assess the efficacy of combined betaine-fibrate therapy.
- This combination may offer a strategy to reduce residual cardiovascular risk.
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