Effects of initial BMI and on-treatment weight change on the lipid-lowering efficacy of fibrates

Abstract

OBJECTIVE: To assess the effects of BMI at baseline and on-treatment weight change on the lipid-lowering efficacy of diet plus fibric acid derivatives (fibrates) in hypercholesterolemic adults. SUBJECTS: 6003 participants in a Belgian General Practitioners Trial, an open-label, prospective study conducted in a primary care setting. MEASURES: Effect of initial BMI, on-treatment weight change, or lipid values at baseline on percentage changes in low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG). Multiple linear regression models, including initial BMI, on-treatment weight change, age, gender, and baseline lipid values, were fitted to control the influences exerted by these variables on each other. RESULTS: Reductions in LDL-C after diet plus fibrate treatment for 12 weeks were inversely related to initial BMI and to TG levels at baseline, and were positively associated with baseline LDL-C concentrations and with on-treatment weight change (P<0.001 for all analyses). Decreases in TG related negatively with initial BMI (P=0.012), and positively with weight loss (P=0.011) and TG at baseline (P<0.001). Increases in HDL-C were negatively associated with initial BMI (P=0.012) and with baseline TG (P<0.001). CONCLUSIONS: The LDL-C lowering efficacy of fibrates is inversely related to initial BMI, and is positively associated with on-treatment weight loss.