Back to Search
Start Over
Combination thiazolidinedione and fibrate effect on high-density lipoprotein cholesterol (HDL-C) concentration in a Veterans Affairs patient population
- Source :
- Journal of clinical lipidology. 2(6)
- Publication Year :
- 2008
-
Abstract
- Background Type 2 diabetes mellitus (T2DM) is a coronary heart disease (CHD) risk equivalent warranting aggressive management of dyslipidemia and tight glycemic control. Recent reports demonstrate a paradoxic decrease in high-density lipoprotein cholesterol (HDL-C) with thiazolidinedione (TZD) and fibrate combination therapy. Objective Evaluate change in HDL-C from start of combination therapy to 1 year and assess the proportion, characteristics, and regimens of patients who developed a ≥20% decrease in HDL-C from baseline. Methods Patients with T2DM treated concurrently with a combination of TZD and fibrate were identified through retrospective query from a Veterans Affairs medical center database. HDL-C was recorded for 1 year after patients started combination therapy. Logistic regression analysis was performed to determine any predictors of HDL-C change. Results A total of 322 patients were included in the analysis. There was no significant differences in mean ± standard deviation HDL-C from baseline to end point (36.8 ± 8.5 to 40.3 ± 11.8 mg/dL; P = 0.097). There was a subset of patients identified (13%; n=43) on combination therapy who experienced a ≥20% reduction in HDL-C. Of these patients, a decrease in HDL-C was more likely to occur with fenofibrate-based regimens (odds ratio 3.08, 95% confidence interval 1.22 to 7.75; P = 0.018). There was a trend toward more of these patients in this subset to have the combination of rosiglitazone and fenofibrate in their profiles (odds ratio 2.82, 95% confidence interval 0.98 to 8.0; P = 0.064). Conclusion Our study demonstrated that a subset of patients with T2DM experienced a paradoxic decrease in HDL-C when taking a fibrate and TZD combination.
- Subjects :
- medicine.medical_specialty
Nutrition and Dietetics
Fenofibrate
Combination therapy
medicine.drug_class
business.industry
Endocrinology, Diabetes and Metabolism
nutritional and metabolic diseases
Odds ratio
Fibrate
medicine.disease
Confidence interval
Endocrinology
Internal medicine
Internal Medicine
medicine
Cardiology and Cardiovascular Medicine
Rosiglitazone
business
Veterans Affairs
Dyslipidemia
medicine.drug
Subjects
Details
- ISSN :
- 19332874
- Volume :
- 2
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Journal of clinical lipidology
- Accession number :
- edsair.doi.dedup.....b189f895eee208fadb1928eaead2a96f