Peroxisome proliferator-activated receptor (
PPAR)α activators (
fibrates) are one of the major group of
hypolipidemic agents. Apart from lowering plasma
lipid levels,
fibrates produce many other favourable effects that may potentially contribute to their clinical effectiveness. Administered to patients with abnormal
glucose and
lipid homeostasis participating in our studies, these agents reduced monocyte and lymphocyte secretory function, systemic
inflammation, hemostasis and normalized adipose tissue function and these effects did not correlate with their
lipid-lowering properties. These beneficial pleiotropic effects were observed in patients with mixed
dyslipidemia, isolated
hypertriglyceridemia,
impaired glucose tolerance,
metabolic syndrome and
type 2 diabetes mellitus and their strength was similar to that of
statins. However, large clinical trials assessing
fibrate effectiveness in the primary and
secondary prevention of
cardiovascular diseases provided contrasting results. In our article, we summarise the present state of knowledge on the role of
fibrates in the treatment of metabolic disorders, which leads to the conclusion that
fibrates are most probably efficient in primary and
secondary prevention of
cardiovascular diseases, particularly in patients with mixed
dyslipidemia and
lipid abnormalities coexisting with disorders of carbohydrate metabolism.