DIFFERENCES IN THE RESPONSE OF SERUM-LIPOPROTEINS TO FENOFIBRATE BETWEEN WOMEN AND MEN WITH PRIMARY HYPERCHOLESTEROLEMIA

Objective: We studied possible sex differences of the effect of fenofi brate on serum lipoproteins. Twenty-three patients with primary hyperc holesterolaemia (10 postmenopausal women and 13 aged-matched men) were treated with slow-release fenofibrate for 96 weeks. Results: Steady s tate 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 an d low-density lipoprotein (LDL) cholesterol decreased from 299 to 234 mg . dl 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 significant ly 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 opposi te directions, the decrease in LDL/HDL cholesterol ratio was accentuat ed in both groups. However, this ratio was decreased almost twofold in women (-41%) compare to men (-23%). Although the serum concentrations of fenofibric acid were 1.3-fold higher in women than in men, which w as probably due to the higher body weight in men (1.2-fold), this diff erence can hardly explain the favorable effect on lipoproteins in wome n. Conclusion: The present study indicates that fenofibrate might be v ery effective by reducing the concentrations of atherogenic lipoprotei ns in postmenopausal women.