Effect of Fibrate on Lipoprotein(a) Level in Hypertriglyceridemic Patients

Kim, Sung Jin; Lee, Kyung Eun; Lee, Sung Ho; Jung, Kap Sung; Lee, Kwang Je; Kim, Tae Ho; Ko, Hong Sook; Kim, Chee Jeong; Ryu, Wang Seong

Abstract

BACKGROUND AND OBJECTIVES
The responses of lipoprotein (a) [Lp(a)] to lipid-lowering drugs are different from those of other lipids and lipoproteins. Most reports on the effect of fibrate on the Lp (a) level have only a few cases, with inconsistent results. This study was designed to evaluate the effect of fibrate on the Lp (a) level in hypertriglyceridemic patients.
SUBJECTS AND METHODS
Patients with either a triglyceride (TG) level over 300mg/dL or TG level over 200mg/dL and a high density lipoprotein cholesterol level below 40mg/dL, were enrolled. They were treated with either fibrate (Fibrate group, n=29) or general measures (Control group, n=29). Gender and age matched patients with hypercholeste-rolemia were adopted and treated with statin (Statin group, n=29). The lipid and lipoprotein levels were measured before and after the medication for 2 months.
RESULTS
The baseline Lp (a) levels were similar between the Fibrate and Control groups (p=0.19). Fibrate therapy increased the Lp (a) level from 10.3+/-16.4 to 15.1+/-15.2 mg/dL (p=0.003), but there were no changes in the Lp (a) levels in the Statin and Control groups. Before the treatment, the Lp (a) levels were negatively associated with the TG levels (r=-0.36, p=0.001). The relationship became weaker and insignificant after the medication. The more the TG level was decreased, the more the Lp (a) level was increased in all of the cases (r=-0.35, p=0.001 ) as well as in the Fibrate group (r=-0.46, p=0.013).
CONCLUSION
Fibrate increased the Lp (a) level, and this elevation was associated with the reduction in the TG level. This finding might be related with a lesser cardioprotective effect of fibrate than that of statin in addition to the effect on the cholesterol level.