Fenofibrate and extended-release niacin improve the endothelial protective effects of HDL in patients with metabolic syndrome

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#cells-cultured #cholesterol-hdl #cross-over-studies #delayed-action-preparations #endothelial-cells

Fenofibrate and extended-release niacin improve the endothelial protective effects of HDL in patients with metabolic syndrome

Gomaraschi et al., 2015 | Vascul Pharmacol | Rct

Citation

Gomaraschi Monica, Ossoli Alice, ... Calabresi Laura. Fenofibrate and extended-release niacin improve the endothelial protective effects of HDL in patients with metabolic syndrome. Vascul Pharmacol. 2015-Nov;74:80-86. doi:10.1016/j.vph.2015.06.014

Abstract

BACKGROUND: Fibrates and niacin are at present the most effective therapies to increase plasma levels of high density lipoprotein-cholesterol (HDL-C); to date, limited data are available on their effects on HDL protective functions. METHODS AND RESULTS: Within a multicenter, randomized, open-label, cross-over study, 37 patients with metabolic syndrome received 6weeks' treatment with fenofibrate or extended-release niacin (ER niacin), with a 4weeks' wash-out period. HDL ability to preserve endothelial cell homeostasis was assessed by incubating cultured endothelial cells with HDL isolated from patients at baseline and after each treatment. HDL isolated from patients at baseline were as effective as control HDL in inhibiting vascular cell adhesion molecule-1 (VCAM-1) expression, but less efficient in promoting endothelial cell nitric oxide (NO) release. Both fenofibrate and ER niacin increased HDL ability to inhibit TNFα-induced VCAM-1 expression (+7% and +11%, respectively). Fenofibrate and ER niacin also improved the impaired HDL ability to induce the expression of endothelial nitric oxide synthase and NO production (+10% and +8%, respectively). Interestingly, HDL isolated after treatment showed an ability to promote endothelial NO release similar to HDL isolated from controls. No differences were observed between the two drugs. With both drugs, HDL function was improved irrespective of baseline HDL-C levels. CONCLUSION: Treatment with fenofibrate or ER niacin in patients with metabolic syndrome not only increased HDL-C levels but also improved the endothelial protective effects of HDL.

Key Findings

Within a multicenter, randomized, open-label, cross-over study, 37 patients with metabolic syndrome received 6weeks' treatment with fenofibrate or extended-release niacin (ER niacin), with a 4weeks' wash-out period. HDL ability to preserve endothelial cell homeostasis was assessed by incubating cultured endothelial cells with HDL isolated from patients at baseline and after each treatment. HDL isolated from patients at baseline were as effective as control HDL in inhibiting vascular cell adhesio

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population metabolic syndrome received 6weeks
Sample Size 37
Age Range See abstract
Condition See abstract

MeSH Terms

  • Cells, Cultured
  • Cholesterol, HDL
  • Cross-Over Studies
  • Delayed-Action Preparations
  • Endothelial Cells
  • Female
  • Fenofibrate
  • Humans
  • Hypolipidemic Agents
  • Male
  • Metabolic Syndrome
  • Middle Aged
  • Niacin
  • Nitric Oxide Synthase Type III
  • Protective Agents
  • Vascular Cell Adhesion Molecule-1

Evidence Classification

  • Level: Rct
  • Publication Types: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
  • Vertical: niacin-cholesterol

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09