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About the Authors:
Kees van Bochove
Contributed equally to this work with: Kees van Bochove, Daniël B. van Schalkwijk
Affiliation: Department of Microbiology and Systems Biology, TNO, Zeist and Leiden, The Netherlands
Daniël B. van Schalkwijk
Contributed equally to this work with: Kees van Bochove, Daniël B. van Schalkwijk
* E-mail: [email protected]
Affiliations Department of Microbiology and Systems Biology, TNO, Zeist and Leiden, The Netherlands, Analytical Sciences Division, The Leiden Amsterdam Centre for Drug Research, Leiden, The Netherlands, The Netherlands Bioinformatics Centre (NBIC), Nijmegen, The Netherlands
Laurence D. Parnell
Affiliation: The Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts, United States of America
Chao-Qiang Lai
Affiliation: The Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts, United States of America
José M. Ordovás
Affiliation: The Nutrition and Genomics Laboratory, JM-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts, United States of America
Albert A. de Graaf
Affiliation: Department of Microbiology and Systems Biology, TNO, Zeist and Leiden, The Netherlands
Ben van Ommen
Affiliation: Department of Microbiology and Systems Biology, TNO, Zeist and Leiden, The Netherlands
Donna K. Arnett
Affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
Introduction
Fibrates are prescribed to lower plasma triglycerides and raise HDL cholesterol (HDLc) in dyslipidemic patients. These drugs are not universal in efficacy; patients respond heterogeneously, and the most recent data show that fibrates only reduce cardiovascular events in specific subgroups [1]–[3]. It is therefore important to find improved methods for identifying those patients that will respond positively to fibrate treatment.
The fact that patients respond heterogeneously to fibrates has been documented in most of the large clinical trials conducted with fibrates [4]–[11]. Subgroups with high triglycerides [8], [12], high HDLc [12], a combination of high triglycerides with low HDLc or a combination of high triglycerides with a high LDLc/HDLc ratio [12], [13] and diabetic or insulin resistant subjects [14] all proved to have increased benefit from fibrates in specific studies, when compared to the general population. Because different studies use different methods for defining subgroups, apparently it is a challenge to optimally define the patient subgroup which stands to see the greatest benefit.