Korean J Lab Med.  2010 Feb;30(1):17-19. 10.3343/kjlm.2010.30.1.17.

HDL Cholesterol Reduction during Rosiglitazone and Fenofibrate Treatment in a Type 2 Diabetes Mellitus Patient with Dyslipidemia

• Im M
• Kim M
• Lee JK
• Chang YH
• Lee DY
• Hong SI
• Lee YY
• Hong YJ

• KMID: 1096813
• DOI: http://doi.org/10.3343/kjlm.2010.30.1.17

Abstract

Thiazolidinediones (TZD), which are widely used as insulin sensitizers, and fibrates, which are lipid-lowering drugs, are used in the treatment of dyslipidemia that commonly accompanies diabetes. Several reports suggest elevated levels of high-density lipoprotein (HDL) cholesterol, but the paradoxical reduction of HDL cholesterol level during single or combined TZD and fibrate therapies has been occasionally reported. Herein, we report a case of paradoxical decrease in HDL cholesterol and apolipoprotein A-1 levels during rosiglitazone and fenofibrate treatment for the first time in Korea. The patient was a 56-yr-old man presenting with type 2 diabetes mellitus and dyslipidemia. His HDL cholesterol and apolipoprotein A-1 levels returned to normal after the cessation of fenofibrate therapy. Since diabetes is an established risk factor of cardiovascular diseases, low HDL cholesterol can be a key cause of concern for patients with diabetes. Therefore, HDL cholesterol level should be determined before and after starting TZD and/or fibrate therapy in diabetic patients.

Keyword

HDL cholesterol; Rosiglitazone; Fenofibrate

MeSH Terms

Apolipoprotein A-I/metabolism
Cholesterol, HDL/*blood
Diabetes Mellitus, Type 2/complications/*drug therapy
Dyslipidemias/complications/*drug therapy
Fenofibrate/*therapeutic use
Humans
Hypolipidemic Agents/*therapeutic use
Male
Middle Aged
Thiazolidinediones/*therapeutic use

Figure

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  Fig. 1. Diagrammatic representation of the serum lipid levels in relation to oral hypoglycemic and lipid-lowering therapy.

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