Long-Term Effects of Fenofibrate on Carotid Intima-Media Thickness and Augmentation Index in Subjects With Type 2 Diabetes Mellitus
Long-Term Effects of Fenofibrate on Carotid Intima-Media Thickness and Augmentation Index in Subjects With Type 2 Diabetes Mellitus
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DOI：
10.1016/j.jacc.2008.09.049
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发表时间：
2008-12-16
影响因子：
24
通讯作者：
Taskinen, Marja-Riitta
中科院分区：
文献类型：
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作者：
Hiukka, Anne;Westerbacka, Jukka;Taskinen, Marja-Riitta
目的本子研究的目的是确定是否长期治疗与非诺贝特减少动脉粥样硬化的替代措施，炎症的生物标志物，和2型diabetes.Background患者的内皮激活一些贝特类药物可能会减少心血管事件，改善内皮功能，并降低急性时相蛋白的水平。在FIELD（非诺贝特干预和事件降低糖尿病）研究中，非诺贝特未能降低2型diabetes.Methods患者的冠状动脉事件的主要终点，共有170例2型糖尿病患者的FIELD赫尔辛基队列随机分配到微粒化非诺贝特200毫克/天或安慰剂的双盲设计。颈动脉内膜中层厚度（IMT）和增强指数（测量大动脉硬度）在基线和第二年和第五年的访问。采用酶联免疫吸附测定法检测两组患者血浆白细胞介素（IL）-6、C反应蛋白（CRP）、血清淀粉样蛋白A（SAA）、分泌型磷脂酶A2 Ⅱ A（SPLA 2）、E选择素、血管细胞粘附分子（VCAM）-1和细胞间粘附分子（CAM）-1水平。CRP，IL-6，SPLA 2，SAA，VCAM-1，ICAM-1，和E-选择素的血浆水平保持不变，在两个group.Conclusions非诺贝特治疗与有益的变化，IMT，扩增指数，或炎症和内皮功能的生物标志物。（非诺贝特干预和降低糖尿病事件; NCT 00132886）（J Am科尔Cardiol 2008; 52：2190-7）c 2008年美国心脏病学会基金会
Objectives The aim of this substudy was to ascertain whether long-term treatment with fenofibrate reduces surrogate measures of atherosclerosis, biomarkers of inflammation, and endothelial activation in patients with type 2 diabetes.Background Some fibrates may decrease cardiovascular events, improve endothelial function, and reduce levels of acute-phase proteins. In the FIELD (Fenofibrate Intervention and Event Lowering in Diabetes) study, fenofibrate failed to decrease the primary end point of coronary events in patients with type 2 diabetes.Methods A total of 170 patients with type 2 diabetes of the FIELD Helsinki cohort were randomly assigned to micronized fenofibrate 200 mg/day or placebo in a double-blind design. Carotid intima-media thickness (IMT) and the augmentation index (a measure of large artery stiffness) were measured at baseline and at second- and fifth-year visits. Plasma levels of interleukin (IL)-6, C-reactive protein (CRP), serum amyloid A (SAA), secretory phospholipase A2 IIA (SPLA2), E-selectin, vascular cellular adhesion molecule (VCAM)-1, and intercellular adhesion molecule (CAM)-1 were determined by commercial enzyme-linked immunosorbent assay kits at the same visits.Results IMT and the augmentation index increased similarly in both treatment groups during the study. Plasma levels of CRP, IL-6, SPLA2, SAA, VCAM-1, ICAM-1, and E-selectin remained unchanged in both groups.Conclusions Fenofibrate treatment was not associated with beneficial changes in IMT, augmentation index, or biomarkers of inflammation and endothelial function. (Fenofibrate Intervention and Event Lowering in Diabetes; NCT00132886) (J Am Coll Cardiol 2008; 52: 2190-7) c 2008 by the American College of Cardiology Foundation