Effect of Fibrate Treatment on Circulating Adipokine Levels: A Systematic Review and Meta-analysis of Randomized Clinical Trials

Abstract

Background

Fibrates are widely used in the treatment of dyslipidemia and associated metabolic abnormalities; however, their effects on adipokines are unclear. Aim of the study. This meta-analysis of clinical trials aimed to evaluate the effect of fibrates on circulating adipokine levels.

Methods

Only randomized controlled trials investigating the impact/effect of fibrate treatment on circulating adipokine levels were included from searches in PubMed-Medline, SCOPUS, ClinicalTrials.gov, Web of Science, and Google Scholar databases. A random effects model and the generic inverse variance method were used for the meta-analysis. Sensitivity analysis was conducted using the leave-one-out method.

Results

This meta-analysis of 22 clinical trials showed a significant reduction on/in leptin (WMD: –1.58 ng/mL, 95% CI: –2.96, –0.20, p = 0.02, I² = 0%), plasminogen activator inhibitor-1 (PAI-1) (WMD: –13.86 ng/mL, 95% CI: –26.70, –1.03, p = 0.03, I² = 99%), and visfatin (WMD: –1.52 ng/mL, 95% CI: –2.49, –0.56, p = 0.002, I² = 0%) after fibrate therapy; no significant effect was observed on adiponectin (WMD: –0.69 µg/ml, 95% CI: –1.40, 0.02, p = 0.06, I² = 83%) and resistin (WMD: –2.27 ng/mL, 95% CI: –7.11, 2.57, p = 0.36, I² = 0%). The sensitivity analysis was robust only for visfatin, while the effect size was sensitive to one arm for leptin, four for adiponectin, and two for PAI-1.

Conclusion

This meta-analysis showed that fibrate treatment significantly improves adipokine levels with a decrease in leptin, PAI-1, and visfatin, suggesting potential additional clinical therapeutic benefits through/of fibrate treatment on adipose tissue.