HDL Cholesterol Reduction during Rosiglitazone and Fenofibrate Treatment in a Type 2 Diabetes Mellitus Patient with Dyslipidemia
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Thiazolidinediones (TZD), which are widely used as insulin sensitizers, and fibrates, which are lipid-lowering drugs, are used in the treatment of dyslipidemia that commonly accompanies diabetes. Several reports suggest elevated levels of high-density lipoprotein (HDL) cholesterol, but the paradoxical reduction of HDL cholesterol level during single or combined TZD and fibrate therapies has been occasionally reported. Herein, we report a case of paradoxical decrease in HDL cholesterol and apolipoprotein A-1 levels during rosiglitazone and fenofibrate treatment for the first time in Korea. The patient was a 56-yr-old man presenting with type 2 diabetes mellitus and dyslipidemia. His HDL cholesterol and apolipoprotein A-1 levels returned to normal after the cessation of fenofibrate therapy. Since diabetes is an established risk factor of cardiovascular diseases, low HDL cholesterol can be a key cause of concern for patients with diabetes. Therefore, HDL cholesterol level should be determined before and after starting TZD and/or fibrate therapy in diabetic patients. (Korean J Lab Med 2010;30:17-9)
Abstract
Thiazolidinediones (TZD), which are widely used as insulin sensitizers, and fibrates, which are lipid-lowering drugs, are used in the treatment of dyslipidemia that commonly accompanies diabetes. Several reports suggest elevated levels of high-density lipoprotein (HDL) cholesterol, but the paradoxical reduction of HDL cholesterol level during single or combined TZD and fibrate therapies has been occasionally reported. Herein, we report a case of paradoxical decrease in HDL cholesterol and apolipoprotein A-1 levels during rosiglitazone and fenofibrate treatment for the first time in Korea. The patient was a 56-yr-old man presenting with type 2 diabetes mellitus and dyslipidemia. His HDL cholesterol and apolipoprotein A-1 levels returned to normal after the cessation of fenofibrate therapy. Since diabetes is an established risk factor of cardiovascular diseases, low HDL cholesterol can be a key cause of concern for patients with diabetes. Therefore, HDL cholesterol level should be determined before and after starting TZD and/or fibrate therapy in diabetic patients. (Korean J Lab Med 2010;30:17-9)
참고문헌 (14)
- Lebovitz HE, "Rosiglitazone monotherapy is effective in patients with type 2 diabetes", J Clin Endocrinol Metab, 86, pp.280~288 (2001)
- Staels B, "Mechanism of action of fibrates on lipid and lipoprotein metabolism", Circulation, 98, pp.2088~2093 (1998)
- Norme@n L, "Combination therapy with fenofibrate and rosiglitazone paradoxically lowers serum HDL cholesterol", Diabetes Care, 27, pp.2241~2242 (2004)
- World Health Organization, "WHO drug information", World Health Organization, 19, pp.208~ (2005)
- Capps NE, "Lipid profiles on fibric-acid derivatives", Lancet, 344, pp.684~685 (1994)
- Chandler HA, "Ciprofibrate and lipid profile", Lancet, 344, pp.128~129 (1994)
- Shetty C, "Paradoxical HDL-C reduction during rosiglitazone and fibrate treatment", Diabet Med, 24, pp.94~97 (2007)
- Sarker A, "Severe hypo-alpha-lipoproteinemia during treatment with rosiglitazone", Diabetes Care, 27, pp.2577~2580 (2004)
- Senba H, "Severe decrease in serum HDLcholesterol during combination therapy of bezafibrate and pioglitazone", J Atheroscler Thromb, 13, pp.263~264 (2006)
- Collinson PO, "Paradoxical high-density lipoprotein reduction induced by fenofibrate and ciprofibrate", Ann Clin Biochem, 33, pp.159~161 (1996)
- Beghin L, "Metabolism of apolipoproteins AI and AII in a patient with paradoxical reduction in high-density lipoprotein due to ciprofibrate", Ann Clin Biochem, 36, pp.523~525 (1999)
- Ebcioglu Z, "Paradoxical lowering of high-density lipoprotein cholesterol level in 2 patients receiving fenofibrate and a thiazolidinedione", Ann Intern Med, 139, pp.80~ (2003)
- Vu-Dac N, "The nuclear receptors peroxisome proliferatoractivated receptor alpha and Rev-erbalpha mediate the species-specific regulation of apolipoprotein A-I expression by fibrates", J Biol Chem, 273, pp.25713~25720 (1998)
- Keidar S, "High incidence of reduced plasma HDL cholesterol in diabetic patients treated with rosiglitazone and fibrate", Pharmacoepidemiol Drug Saf, 16, pp.1192~1194 (2007)