Articles producció científica> Medicina i Cirurgia

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

  • Datos identificativos

    Identificador: PC:1511
    Autores:
    Sahebkar A, Hernández-Aguilera A, Abelló D, Sancho E, Camps J, Joven J.
    Resumen:
    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.
  • Otros:

    Autor según el artículo: Sahebkar A, Hernández-Aguilera A, Abelló D, Sancho E, Camps J, Joven J.
    Departamento: Medicina i Cirurgia
    Autor/es de la URV: CAMPS ANDREU, JORGE; HERNÁNDEZ AGUILERA, ANA; JOVEN MARIED, JORGE
    Palabras clave: Cardiovascular risk HDL Hypertriglyceridemia
    Resumen: 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.
    Grupo de investigación: Unitat de Recerca Biomèdica
    Áreas temáticas: Ciències de la salut Ciencias de la salud Health sciences
    Acceso a la licencia de uso: https://creativecommons.org/licenses/by/3.0/es/
    ISSN: 0026-0495
    Identificador del autor: 0000-0003-0954-295X; 0000-0003-2749-4541
    Fecha de alta del registro: 2016-05-03
    Página final: 622
    Volumen de revista: 65
    Versión del articulo depositado: info:eu-repo/semantics/acceptedVersion
    Enlace a la fuente original: https://www.metabolismjournal.com/article/S0026-0495(16)00005-6/fulltext#%20
    URL Documento de licencia: https://repositori.urv.cat/ca/proteccio-de-dades/
    DOI del artículo: 10.1016/j.metabol.2016.01.002
    Entidad: Universitat Rovira i Virgili
    Año de publicación de la revista: 2016
    Página inicial: 609
    Tipo de publicación: Article Artículo Article
  • Palabras clave:

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