Peroxisome proliferator-activated receptor gene expression alterations

Overall, fibrates decrease plasma triglyceride levels much more dramatically than they decrease plasma cholesterol levels. They significantly decrease VLDL levels, cause a moderate Increase In HDL levels, and have variable effects on LDL concentrations. As an example of this latter point, gemfibrozil will raise LDL levels In patients with hypertriglyceridemia but lower LDL levels in patients with normal triglyceride levels. The exact mechanisms for these actions have not been fully elucidated however, studies have shown that this class of compounds can produce a variety of beneficial effects on lipoprotein metabolism. Many of these effects have been proposed to be mediated through the activation of peroxisome proliferator-activated receptors (PPARs) and an alteration of gene expression. Specifically, fibrates bind to PPARa (7,15,27,44). 

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