Effect of fibrate treatment on liver function tests in patients with the metabolic syndrome

Background: Fibrates are used especially in patients with hypertriglyceridaemia, a feature of the metabolic syndrome. Elevated LFTs are often observed in these patients perhaps related to fatty infiltration. Aim: We wished to study changes seen in LFTs (GGT, ALT and ALP) following fibrate therapy and then determine associated factors. Methods: This was a retrospective observational study in which data was collected from case notes of patients started on fibrates (n = 118, 2002–2008) in the lipid clinic at Good Hope Hospital and pre/post-fibrate lipid and LFT values were obtained. All biochemistry was performed on the Roche P-Unit using supplied reagents. Statistical analyses included t tests and regression analyses (factorised when quartiles were compared). Results: Of the study population 106 patients were on fenofibrate; the remaining on bezafibrate. Significant lowering of GGT (p 57 IU/l, ALT> 34 IU/l and ALP>94 IU/l) significantly different to the lowest quartile. The above associations remained significant even when the regression analyses were corrected for changes in lipid values (which did not show an association).