Differences in the response of serum lipoproteins to fenofibrate between women and men with primary hypercholesterolaemia

Abstract

Objective:

We studied possible sex differences of the effect of fenofibrate on serum lipoproteins. Twenty-three patients with primary hypercholesterolaemia (10 postmenopausal women and 13 aged-matched men) were treated with slow-release fenofibrate for 96 weeks.

Results:

Steady state lipoprotein concentrations were reached after 12 and 24 weeks of treatment in women and men, respectively. During the subsequent follow-up the lipoprotein concentrations remained constant. In women total and low-density lipoprotein (LDL) cholesterol decreased from 299 to 234 mg⋅dl⁻¹ and from 210 to 151 mg⋅dl⁻¹, respectively, and in men from 265 to 233 mg⋅dl⁻¹ and from 192 to 160 mg⋅dl⁻¹. The decrease in triglycerides was also more pronounced in women (−42%) than in men (−18%). High-density lipoprotein (HDL) cholesterol increased significantly in women from 53 to 63 mg⋅dl⁻¹ but not in men (45 to 50 mg⋅dl⁻¹). Since the changes in LDL and HDL cholesterol occurred in opposite directions, the decrease in LDL/HDL cholesterol ratio was accentuated in both groups. However, this ratio was decreased almost twofold in women (−41%) compared to men (−23%). Although the serum concentrations of fenofibric acid were 1.3-fold higher in women than in men, which was probably due to the higher body weight in men (1.2-fold), this difference can hardly explain the favorable effect on lipoproteins in women.

Conclusion:

The present study indicates that fenofibrate might be very effective by reducing the concentrations of atherogenic lipoproteins in postmenopausal women.