A COMPARISON OF THE EFFECTS OF FLUVASTATIN AND BEZAFIBRATE ON EXERCISE METABOLISM - A PLACEBO-CONTROLLED STUDY IN HEALTHY NORMOLIPIDEMIC SUBJECTS

1 We have examined the interaction between aerobic exercise and lipid- lowering drugs in a crossover study of 16 healthy normolipidaemic volu nteers who each received 21 days' treatment with bezafibrate (400 mg), fluvastatin (40 mg), and placebo, in random order. 2 Fluvastatin trea tment reduced pre-exercise total cholesterol (TC) by 23% (P<0.0001), l ow-density lipoprotein cholesterol (LDL-C) by 33% (P<0.0001), and plas ma triglycerides by 11%, compared with pre-treatment values. Bezafibra te reduced TC by 11% (P<0.01); LDL-C by 9%; and plasma triglycerides b y 40% (P<0.01), compared with pre-treatment values. 3 During exercise, in comparison with placebo, and fluvastatin treatment, respectively, bezafibrate significantly reduced mean fat oxidation: 31% vs 39%, P=0. 035, 31% vs 39%, P=0.002, plasma free fatty acid (FFA) availability, e .g. after 90 min of exercise: (t90) 520 vs 662 mu mol l(-1), P=0.054, 520 vs 725 mu mol 1(-1), P=0.016, and plasma levels of glycerol (t90): 59 vs 74 mu mol l(-1), P=0.037, 59 vs 73 mu mol l(-)1, P=0.016. Fluva statin had no impact on fat metabolism in comparison with placebo. 4 R educed plasma FFA concentration and lower fat oxidation during prolong ed exercise on bezafibrate treatment may be due to an inhibition of he patic acetyl coenzyme A carboxylase, resulting in reduced FFA release from adipose tissue. 5 The possibility that impaired fat metabolism on fibrates could induce premature fatigue during exercise of moderate d uration and intensity should be examined in hyperlipidaemic patients.