Are the lipid-modifying effects of fibrates mediated by alterations in plasma lipid transfer activity?

Fenofibrate, a PPAR-α (peroxisome-proliferator-activated receptor-α) agonist, has been shown to modify plasma lipid and lipoprotein composition and metabolism by a variety of mechanisms. In addition, fenofibrate has been shown to increase the activity of PLTP (phospholipid transfer protein) and to reduce the activity of CETP (cholesteryl ester transfer protein). It is not known, however, whether the changes in PLTP and CETP plasma activity play an active role in the lipid changes observed with fenofibrate therapy, and this is investigated by Watts and co-workers in the present issue of Clinical Science.