Fibrates, or fibric acid derivatives, are a class of cholesterol-lowering drugs that have the potential to affect all aspects of your lipid panel.
The manner by which fibrates lower cholesterol is complex. Fibrates are thought to activate a protein called peroxisome proliferator-activated receptor alpha (PPAR-alpha). This protein can activate another enzyme, lipoprotein lipase, which can decrease the amount of
apolipoprotein C-III in the body. Ultimately, this results in decreased formation of
VLDL and
triglycerides, increased breakdown of lipids, and increase in
HDL (the “good” cholesterol) levels. Fibrates can also convert small, dense
LDL cholesterol to normal-sized LDL cholesterol molecules. Small, dense LDL cholesterol can increase the formation of atherosclerotic
plaque. Currently, three fibrates are on the U.S. market:
Fibrates are mostly known for lowering triglycerides. However, they can affect all aspects of your lipid profile:
- They lower LDL cholesterol, or “bad” cholesterol, by 5% to 20%.
- They raise HDL cholesterol, or “good” cholesterol, by 10% to 35%.
- They lower triglycerides by 20% to 50%.
Fibrates can be used alone, or in combination with other lipid lowering agents, in order to effectively lower your
cholesterol.
Source:
Third Report of the National Cholesterol Education Program
(NCEP) Expert Panel on Detection, Evaluation, and Treatment of
High Blood Cholesterol in Adults (PDF), July 2004, The National Institutes of Heath: The National Heart, Lung, and Blood Institute.
