The purpose of this study is to determine whether atorvastatin and fenofibrate are effective in the treatment of lipid disorders in obese, insulin resistant subjects.

Insulin resistance is a heterogeneous metabolic disorder of complex etiology. It underpins dyslipoproteinemia, a key feature of the metabolic syndrome (MetS) that independently predicts cardiovascular disease (CVD). Hypertriglyceridemia, the most consistent lipid disorder in subjects with obesity and type 2 diabetes mellitus, is chiefly a consequence of overproduction and delayed clearance of triglyceride-rich lipoproteins (TRLs). Although the precise mechanisms involved are incompletely understood, experimental and clinical evidence suggests that elevated apolipoprotein (apo) C-III may play a crucial role in the dysregulation of TRL metabolism. investigating the effects of these agents on VLDL-apoC-III kinetics. In this study, we aimed to examine the effect of two lipid-regulating agents, atorvastatin and fenofibrate on VLDL-apoC-III transport. We hypothesized that atorvastatin and fenofibrate would have similar effects on apoC-III transport by decreasing the production and increasing the catabolism of VLDL-apoC-III.

Inclusion Criteria:

any three of the followings

• waist circumference >102cm
• triglycerides >1.7 mmol/L
• HDL-cholesterol <1.05 mmol/L
• blood glucose >6.1 mmol/L
• blood pressure >130/85mmHg

Exclusion Criteria:

• plasma cholesterol >7mmo/L
• triglycerides >4.5mmo/L
• diabetes mellitus (defined by oral glucose tolerance test)
• CVD
• consumption of >30g alcohol/day
• use of agents affecting lipid metabolism
• APOE2/E2 genotype, macroproteinuria
• creatinaemia (>120umol/L)
• hypothyroidism
• abnormal liver and muscle enzymes.