Statins can lower the circulating levels of C reactive protein (CRP). This effect may be relevant because CRP is a predictor of vascular risk. In contrast, the evidence that fibrates lower CRP levels is very limited. The effect of treatment with ciprofibrate (100 mg once daily) was investigated for 8 weeks in 30 patients with primary dyslipidemia. There was a significant (p < 0.01) decrease in median (range) CRP levels by 36.8% from 1.9 mg/L (1.0-6.0 mg/L) to 1.2 mg/L (1.0-5.5 mg/L). Plasma fibrinogen levels were also significantly (p = 0.05) reduced. There was no correlation between the fall in CRP levels and the changes in lipid or fibrinogen levels. These findings support the concept that fibrates, like the statins, lower serum CRP levels. However, fibrates have a different mode of action. Fibrates (with the exception of gemfibrozil) also consistently lower plasma fibrinogen levels. In contrast, the effect of statins on the circulating levels of this coagulation factor remains to be defined. These differences may help in defining the mechanisms responsible for drug-induced changes in the circulating levels of CRP and fibrinogen. A favorable effect on CRP and fibrinogen levels may increase the clinical efficacy of statins and fibrates.
Sir, Measurement of urinary potassium excretion is very helpful in the differential diagnosis of both hypokalaemia and hyperkalaemia. 1,2 To determine urinary potassium excretion, it is preferable to collect a 24-h urine sample. 3 However, this is not feasible in many cases. Random measurement of the urinary potassium concentration is simple to perform but may be less accurate than a 24-h collection, since it is influenced by two independent factors; potassium secretion and water reabsorption in the medulla. 1,4,5 Therefore, the fractional excretion of potassium (FEK +) has been proposed as a useful marker of potassium excretion. 6 This index relates the amount of potassium excreted to the amount filtered.
Glycated haemoglobin (HbA 1c), a marker of average glycaemia during the previous six to eight weeks, is a predictor of microvascular complications in diabetic individuals. However, the role of HbA 1c as a predictor of macrovascular complications (e.g. myocardial infarction or stroke) in these patients is not clearly defined. In contrast, new evidence suggests that HbA 1c can predict the risk of cardiovascular disease in the general population. The potential applications of this test in vascular disease prevention are discussed.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.