Regulation Effects of Fenofibrate and Pravastatin on Lipid and Uric Acid Metabolism in Senile Patients with Metabolic Syndrome

Objective To evaluate the efficacy and safety of combination therapy with pravastatin and fenofibrate in elderly patients with metabolic syndrome(MS) by studying the effect of fenofibrate and pravastatin on lipid and uric acid(UA) metabolism.Methods 205 elderly MS patients with hypertriglyceridemia and hyperuricemia were randomly assigned to fenofibrate group(200 mg fenofibrate,n=70),pravastatin group(10 mg pravastatin,n=69),and combination group(10 mg pravastatin and 200 mg fenofibrate,n=66),the course was all 4 weeks.Blood lipid profiles,serum UA,24h urine UA and adverse effects were assessed.Results ①Serum TG was reduced by 34.0%,whilst HDL-C increased by 16.7% after fenofibrate treatment for 4w.Serum TC and LDL-C were reduced by 10.4% and 11.3%.Serum UA was reduced by 31.5%;24h urine UA was increased by 32.1%(P0.01).②Serum TC and LDL-C were reduced by 13.8% and 16.4% after pravastatin treatment for 4w.Serum TG was reduced by 15.2%,whilst HDL-C increased by 7.1%(P0.01).Serum UA and 24h urine UA were not changed obvious(P0.05).③After 4w treatments,Serum TC,LDL-C and TG were reduced and HDL-C was increased more significantly in combination therapy group,compared with 2 monotherapy groups;Serum UA was reduced by 33.4%;The 24h urine UA was increased by 36.3%(P0.01).Conclusion Fenofibrate treatment could significantly improve lipid and UA metabolism in elderly MS patients with hypertrigluceridemia and hyperuricemia.The anti-hyperuricem effect of fenofibrate is a result of increasing the urinary excretion of UA.Combination therapy is more effective than monotherapy in elderly patients with MS,and is generally safe.