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Diabetes Patients with High Triglycerides and Low HDL Cholesterol Get the Most Benefit From Fenofibrate Treatment: New Data From the FIELD Study
Date:2/26/2009

se with lower triglyceride, and 40% higher in those with low HDL cholesterol (<0.96 mmol/L-37mg/dL) than in those with higher HDL cholesterol. (2, 3)

Low plasma HDL cholesterol (<1.03 mmol/L-40mg/dL in men and <1.3 mmol/L-50mg/dL in women) and elevated triglyceride (greater than or equal to 1.7 mmol/L-150mg/dL ) are key criteria of the metabolic syndrome according to the old definition of the US National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) guidelines.(4)

In the FIELD study over 80% of patients met the NCEP ATPIII criteria for metabolic syndrome.

This latest study from FIELD investigated whether cardiovascular risk and the effects of fenofibrate treatment differed in type 2 diabetes patients with and without the metabolic syndrome. It also examined the effect of more marked atherogenic dyslipidaemia -- the combination of low HDL cholesterol and higher triglycerides (greater than or equal to 2.3 mmol/L-200mg/dL). One in five FIELD patients had marked atherogenic dyslipidaemia and one in four marked high triglycerides.

Patients with marked atherogenic dyslipidaemia had the greatest 5-year risk of cardiovascular disease (17.8% in the placebo group). These patients also derived the greatest clinical benefit from fenofibrate treatment, with a 27% reduction in CVD risk (from 17.8% to 13.5%, P=0.005). This risk was almost two-fold (29.8%) in those patients who already had cardiovascular disease.

Placing the new findings in clinical context, Professor Scott said:

Atherogenic dyslipidemia, characterised by high triglycerides of at least 2.3 mmol/L-200mg/dL and low HDL-C, as defined by ATP III, is a strong contributor to residual vascular risk in millions of patients with diabetes treated with the best standard of care, including statin therapy. These new findings, together with the microvascular benefits associated with fenofibra
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SOURCE Solvay
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