Articles producció científica> Medicina i Cirurgia

Systematic review and meta-analysis deciphering the impact of fibrates on paraoxonase-1 status

  • Identification data

    Identifier: PC:1511
    Authors:
    Sahebkar A, Hernández-Aguilera A, Abelló D, Sancho E, Camps J, Joven J.
    Abstract:
    Objective A significant residual cardiovascular risk is consistently observed in patients treated with statins. A combined treatment with fibrates reduces cardiovascular events in very high-risk patients. Because this is apparently unconnected to an improvement in lipid-related outcomes we hypothesized that the cardioprotective effects of fibrates might be associated with an improvement in paraoxonase-1 (PON1) status. Method The search for existing evidence, using the Medline, Scopus and Cochrane databases, was systematic and followed the PRISMA statement without restrictions on publication date. We excluded non-clinical and observational studies and we extracted data on baseline and post-treatment values of serum PON1 activity and other measurements of PON1 status. Results Nine studies (including 12 treatment arms) in patients with hyperlipidemia, diabetes or metabolic syndrome treated with fibrates, alone or in combination with statins, were included to synthesize results. A meta-analysis of the data using a random-effects model revealed a significant increase in serum PON1 activity following fibrate therapy (WMD: 15.64 U/L, 95% CI: 6.94, 24.34, p < 0.001), an effect that was robust and not sensitive to any particular study. Subgroup analysis indicated differences in the effect size among types of fibrates and that PON1 alterations were associated with high-density lipoprotein cholesterol changes following fibrate therapy. Conclusions Results indicate a significant PON1-enhancing effect of fibrates. Whether this effect is associated with a clinical benefit, although likely, remains to be further investigated.
  • Others:

    Author, as appears in the article.: Sahebkar A, Hernández-Aguilera A, Abelló D, Sancho E, Camps J, Joven J.
    Department: Medicina i Cirurgia
    URV's Author/s: CAMPS ANDREU, JORGE; HERNÁNDEZ AGUILERA, ANA; JOVEN MARIED, JORGE
    Keywords: Cardiovascular risk HDL Hypertriglyceridemia
    Abstract: Objective A significant residual cardiovascular risk is consistently observed in patients treated with statins. A combined treatment with fibrates reduces cardiovascular events in very high-risk patients. Because this is apparently unconnected to an improvement in lipid-related outcomes we hypothesized that the cardioprotective effects of fibrates might be associated with an improvement in paraoxonase-1 (PON1) status. Method The search for existing evidence, using the Medline, Scopus and Cochrane databases, was systematic and followed the PRISMA statement without restrictions on publication date. We excluded non-clinical and observational studies and we extracted data on baseline and post-treatment values of serum PON1 activity and other measurements of PON1 status. Results Nine studies (including 12 treatment arms) in patients with hyperlipidemia, diabetes or metabolic syndrome treated with fibrates, alone or in combination with statins, were included to synthesize results. A meta-analysis of the data using a random-effects model revealed a significant increase in serum PON1 activity following fibrate therapy (WMD: 15.64 U/L, 95% CI: 6.94, 24.34, p < 0.001), an effect that was robust and not sensitive to any particular study. Subgroup analysis indicated differences in the effect size among types of fibrates and that PON1 alterations were associated with high-density lipoprotein cholesterol changes following fibrate therapy. Conclusions Results indicate a significant PON1-enhancing effect of fibrates. Whether this effect is associated with a clinical benefit, although likely, remains to be further investigated.
    Research group: Unitat de Recerca Biomèdica
    Thematic Areas: Ciències de la salut Ciencias de la salud Health sciences
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    ISSN: 0026-0495
    Author identifier: 0000-0003-0954-295X; 0000-0003-2749-4541
    Record's date: 2016-05-03
    Last page: 622
    Journal volume: 65
    Papper version: info:eu-repo/semantics/acceptedVersion
    Link to the original source: https://www.metabolismjournal.com/article/S0026-0495(16)00005-6/fulltext#%20
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Article's DOI: 10.1016/j.metabol.2016.01.002
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2016
    First page: 609
    Publication Type: Article Artículo Article
  • Keywords:

    Hipertriacilgliceridèmia
    Sistema cardiovascular
    Colesterol
    Cardiovascular risk
    HDL
    Hypertriglyceridemia
    Ciències de la salut
    Ciencias de la salud
    Health sciences
    0026-0495
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