Fibrates: Therapeutic potential for diabetic nephropathy?

Kouroumichakis, I.; Papanas, N.; Zarogoulidis, P.; Liakopoulos, V.; Maltezos, E.; Mikhailidis, D.P.

doi:10.1016/j.ejim.2011.12.007

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Fibrates: Therapeutic potential for diabetic nephropathy?

I. Kouroumichakis
- Outpatient Clinic of Obesity, Diabetes and Metabolism, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece
N. Papanas
- Outpatient Clinic of Obesity, Diabetes and Metabolism, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece
- Corresponding author at: G. Kondyli 22, Alexandroupolis 68100, Greece. Fax: +30 2551074723.
P. Zarogoulidis
- Outpatient Clinic of Obesity, Diabetes and Metabolism, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece
V. Liakopoulos
- Division of Nephrology, First Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Greece
E. Maltezos
- Outpatient Clinic of Obesity, Diabetes and Metabolism, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece
D.P. Mikhailidis
- Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital campus, University College London Medical School, University College London (UCL), London NW3 2QG, UK

Received 21 July 2011; received in revised form 4 December 2011; accepted 18 December 2011. published online 19 January 2012.
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Abstract

Despite intensive glucose-lowering treatment and advanced therapies for cardiovascular risk factors, such as hypertension and dyslipidaemia, diabetes mellitus with its macro- and microvascular complications remains a major health problem. Especially diabetic nephropathy is a leading cause of morbidity and mortality, and its prevalence is increasing. Peroxisome proliferator-activated receptor-α (PPAR-α), a member of a large nuclear receptor superfamily, is expressed in several tissues including the kidney. Recently, experimental data have suggested that PPAR-α activation plays a pivotal role in the regulation of fatty acid oxidation, lipid metabolism, inflammatory and vascular responses, and might regulate various metabolic and intracellular signalling pathways that lead to diabetic microvascular complications. This review examines the role of PPAR-α activation in diabetic nephropathy and summarises data from experimental and clinical studies on the emerging therapeutic potential of fibrates in diabetic nephropathy.

Keywords: Dyslipidaemia, Fibrates, Diabetic nephropathy, Metabolic syndrome, Peroxisome proliferator-activated receptor-α