Tactics of dyslipidemias treatment in metabolic syndrome: statins or fibrates?
The article is dedicated to the problem of lipid metabolism disturbances and its role in the pathogenesis of metabolic syndrome (MS) and its complications. We review the numerous international studies have shown the importance of dyslipidemia in the development and progression of cardiovascular disease, evaluating lipid-lowering and pleiotropic properties of statins and fibrates. Data for own comparative analysis of case histories of 66 patients with MS treated with lipid-lowering therapy by micronized fenofibrate (Tricor) and atorvastatin are presented. According to the analysis results, fenofibrate can be recommended for use in patients with low HDL cholesterol level, high triglyceride level, and normal or moderate elevated low density lipoprotein cholesterol level. It is submitted that fibrates have a wide range of favorable nonlipid effects, among which anti-inflammatory, antioxidant, anticoagulant properties, the effect on the functional state of the endothelium of the vasculature, which may play a key role in decrease of risk of cardiovascular complications of metabolic syndrome.

Keywords: fibrates, lipid-lowering therapy, fenofibrate, coronary heart disease, metabolic syndrome, dyslipidemia, statins