What is the role of fibrates in the treatment of hypertriglyceridemia (high triglyceride levels)?

Updated: Dec 19, 2019
  • Author: Mary Ellen T Sweeney, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Fibrates raise HDL, and they may increase LDL, particularly if the triglyceride level is greater than 400 mg/dL. Because LDL particles change from being small and dense to being large and buoyant, they may be less atherogenic. Fibrates activate peroxisome proliferator activated receptor (PPAR) alpha, increasing the activity of lipoprotein lipase, which causes a decrease in triglyceride levels. LDL changes from small, dense morphology to large, buoyant particles that are more rapidly cleared by liver. PPARalpha activation also increases HDL production.


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