微粒化非诺贝特调节老年代谢综合征患者血脂及尿酸代谢的研究

目的观察微粒化非诺贝特(非诺贝特)对老年代谢综合征患者血脂及尿酸代谢的影响,并探讨其潜在机制。方法入选131例老年代谢综合征患者,同时伴有高TG及高尿酸血症,每日顿服非诺贝特胶囊200 mg,疗程为4周。观察治疗前和治疗4周后主要血脂参数、血尿酸、24 h尿尿酸的变化及不良反应。结果非诺贝特治疗4周后:(1)患者血清TG下降最为显著,与基线比较下降49%,血清HDL-C水平升高18%,此外患者血清TC和LDL-C水平也有一定程度的下降(分别为11%和14%);(2)患者血尿酸水平由(472.5±74.8)μmol/L降至(325.0±82.1)μmol/L,下降幅度为31.2%。其中男性患者血尿酸水平下降32.6%,女性患者下降29.7%,差异均有统计学意义(P<0.01)。(3)患者24 h尿尿酸排泄明显增多,由(2 885.2±502.7)μmol/L增加至(3 701.7±768.2)μmol/L,排泄增加28.8%,其中男性24 h尿尿酸排泄高于女性(P<0.01)。结论非诺贝特具有同时改善老年代谢综合征患者的血脂及尿酸代谢异常的双重疗效,能明显促进尿尿酸排泄,且该作用与性别无关。

Effects of micronised fenofibrate on lipid and uric acid metabolism in elderly patients with metabolic syndrome

Objective To evaluate the effect of micronised fenofibrate on lipid and uric acid metabolism in elderly patients with metabolic syndrome (MS) and to explore its potential mechanism. Methods A total of 131 eiderly MS patients with hypertriglyceridemia and hyperuricemia received 200mg of micronised fenofibrate for 4 weeks. Blood lipid profiles,serum uric acid,24 h urine uric acid, and adverse effects were assessed. Results (1)Serum TG was reduced by 49%, whilst HDL-C increased by 18% after micronised fenofibrate treatment for 4 weeks. Moreover,serum TC and LDL-C were reduced by 11% and 14%, respectively. (2)Serum uric acid level was reduced by 31.2% from (472.5±74.8) μmol/L to (325.0±82.1) μmol/L, P<0.01] after treatment. There was difference of decrease in serum uric acid between male and female patients (32.6% and 29.7%, respectively). (3)24 h urine uric acid level was increased by 28.8% from (2885.2±502.7) βmol/L to (3 701.7±768.2) βmol/L, P<0.01]. The 24 h urine uric acid excretion increase was by 30.9% in male patients and by 28.0% in female patients. Conclusion Micronised fenofibrate treatment could significantly improve lipid and uric acid metabolism in elderly MS patients with hypertriglyceridemia and hyperuricemia. The anti-hyperuricemic effect of fenofibrate is a result of increasing the urinary excretion of uric acid.