Abstract

Fenofibrate is a member of the fibrate class of hypolipidemic agents used clinically to treat hypertriglyceridemia and mixed hyperlipidemia. The fibrates were developed primarily on the basis of their cholesterol and triglyceride lowering in rodents. Fibrates have historically been ineffective at lowering triglycerides in experimentally-induced dyslipidemia in nonhuman primate models. The spontaneously obese rhesus monkey is a well-recognized animal model for the study of human obesity and type 2 diabetes, and many of these monkeys exhibit naturally occurring lipid abnormalities, including elevated triglycerides and low HDL cholesterol (HDL-C), similar to patients with type 2 diabetes. To explore whether the obese rhesus model was predictive of the lipid lowering effects of fibrates, we evaluated fenofibrate in six hypertriglyceridemic, hyperinsulinemic, nondiabetic animals in a 20-week, dose-escalating study. The study consisted of a 4-week baseline period, two treatment periods of 10 mg/kg twice daily (b.i.d) for 4 weeks and 30 mg/kg b.i.d. for 8 weeks, and a 4-week washout period. Fenofibrate (30 mg/kg b.i.d) decreased serum triglycerides 55% and LDL-C 27%, whereas HDL-C increased 35%. Apolipoproteins B-100 and C-III levels were also reduced 70% and 29%, respectively. Food intake, body weight, and plasma glucose were not affected throughout the study. Interestingly, plasma insulin levels decreased 40% during the 30 mg/kg treatment period, suggesting improvement in insulin sensitivity.These results support the use of obese rhesus monkey as an excellent animal model for studying the effects of novel hypolipidemic agents, particularly agents that impact serum triglycerides and HDL-C.

Highlights

  • Fenofibrate is a member of the fibrate class of hypolipidemic agents used clinically to treat hypertriglyceridemia and mixed hyperlipidemia

  • Both the peroxisome proliferation response and the lipid modulating effects of fibrates appear to be mediated through the peroxisome proliferator-activated receptor-␣ (PPAR␣), a member of the nuclear hormone receptor superfamily known to induce changes in the transcription of genes encoding enzymes involved in lipid and lipoprotein metabolism

  • We show here that fenofibrate produced the same lipid-lowering effects as have been observed in humans: reductions in serum TG, apoC-III, and small dense LDL cholesterol (LDL-C) along with increases in HDL cholesterol (HDL-C)

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Summary

Introduction

Fenofibrate is a member of the fibrate class of hypolipidemic agents used clinically to treat hypertriglyceridemia and mixed hyperlipidemia. To explore whether the obese rhesus model was predictive of the lipid lowering effects of fibrates, we evaluated fenofibrate in six hypertriglyceridemic, hyperinsulinemic, nondiabetic animals in a 20-week, dose-escalating study. Plasma insulin levels decreased 40% during the 30 mg/kg treatment period, suggesting improvement in insulin sensitivity These results support the use of obese rhesus monkey as an excellent animal model for studying the effects of novel hypolipidemic agents, agents that impact serum triglycerides and HDL-C.—Winegar, D. The TG-lowering activity of fibrates has been attributed to both inhibition of hepatic fatty acid synthesis and increased catabolism of TG-rich lipoproteins [3, 4] This increase in VLDL catabolism results from up-regulation of LPL expression [5] and increased LPL activity due to a reduction in serum apolipoprotein C-III (apoC-III) levels [6, 7]. Several studies have shown that fibrates do not elicit a rodent-type peroxisome proliferation response in primate liver or in primate-derived cultured hepatocytes [18,19,20,21,22,23]

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