Ramachandran, S, Bhartia, M, Jones, A and Strange, RC (2018) Use of fibrates in the Metabolic Syndrome and Diabetics: practical tips. In: RSSDI Diabetes Update 2018. J P Medical Publishers, pp. 356-361.

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Cardiovascular disease (CVD), a cause of mortality worldwide, accounted for 28% of United Kingdom deaths in 20121. Risk reduction is based on improving modifiable risk factors with lipid lowering therapy being particularly useful2. Because of the importance of reducing serum low density lipoprotein cholesterol (LDL-C), statins remain an effective way of reducing CVD risk2. However, despite statin use there remains a high residual CVD risk, due perhaps to other risk associated lipoproteins3. Fibrates may be useful in targeting these atherogenic lipoproteins especially in type 2 diabetes (T2DM) and the metabolic syndrome (MetS)4. We describe evidence of the usefulness of fibrates, identify patient groups who may benefit from their use, outline factors to be monitored during follow-up and describe effective holistic treatment of an anonymised clinic case.
Fibrates activate the peroxisome proliferator-activated receptor (PPAR) α which by upregulating transcription of various proteins associated with lipid metabolism, influences fatty acid and lipoprotein metabolism in hepatic, muscle and renal tissues5. This results in a variable increase in high density lipoprotein cholesterol (HDL-C), a greater reduction in triglycerides (TG) levels and a modest decrease in LDL-C4,5.

Item Type: Book Section
Additional Information: The final version of this article is found published in a book, with the relative information online, which can be found with all relevant information on the publishers site. This can be found in the following places; http://www.jpmedpub.com/bookdetails.aspx?SearchTxt=diabetes%20update&OBookID=2838 https://jaypee.ciplamed.com/book/9789352706181 https://jaypee.ciplamed.com/book/9789352706181/chapter/ch72
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine
R Medicine > RC Internal medicine > RC660 Diabetes
R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
Divisions: Faculty of Medicine and Health Sciences > Institute for Science and Technology in Medicine
Related URLs:
Depositing User: Symplectic
Date Deposited: 26 Sep 2018 09:52
Last Modified: 09 Sep 2020 13:34
URI: https://eprints.keele.ac.uk/id/eprint/5343

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