Objective. To compare extra-lipid effects of statins and fibrates in relationship with the baseline metabolic status of patients.

Research Design and Methods. This study involved the group of 242 metabolic syndrome patients with or without prediabetes, randomized to atorvastatin, fenofibrate or placebo.

Results. Compared to matched healthy subjects, metabolic syndrome patients exhibited higher plasma levels/activities of hsCRP, fibrinogen, factor VII and PAI-1, and exhibited enhanced monocyte cytokine release. All these abnormalities were alleviated by both atorvastatin and fenofibrate treatment. CRP-lowering and monocyte-suppressing actions were more pronounced for atorvastatin in subjects with impaired fasting glucose and for fenofibrate in patients with impaired glucose tolerance.

Conclusions. The presence of prediabetes potentiates metabolic syndrome-induced abnormalities in plasma markers of inflammation, hemostasis, and in monocyte secretory function. Both atorvastatin and fenofibrate exhibit multidirectional pleiotropic effects in subjects with metabolic syndrome, the strength of which seems to be partially determined by the type of prediabetes.