Background:In vascular tissue, macrophages and inflammatory cells produce the enzyme lipoprotein-
associated phospholipase A2 (Lp-PLA2). Treatment with fibrates decreases Lp-PLA2 levels in individuals
with obesity and metabolic syndrome; however, these findings have not been fully clarified.Objective:The goal of this study was to investigate the possible effects of fibrate therapy on Lp-PLA2 mass
and activity through a meta-analysis of clinical trials.Methods:Web of Science, PubMed, Scopus, Google Scholar, and ClinicalTrials.gov databases were searched
using MeSH terms and keywords. Randomized controlled trials (RCT) evaluating the effect of statins on Lp-
PLA2 mass and/or activity were included in the meta-analysis. Quantitative data were analyzed using a random-
effects model and the generic inverse variance method.Results:The meta-analysis of 10 clinical trials indicated that fibrate treatment has no significant effect on Lp-
PLA2 mass (fibrate vs. placebo/nothing = WMD: -3.29 ng/ml, 95% CI: -21.35, 14.78, p = 0.72; fibrate vs. active
control = WMD: -1.08 ng/ml, 95% CI: -51.38, 49.22, p = 0.97); Lp-PLA2 activity (fibrate vs. active control
= WMD: 0.84 nmol/ml/min, 95% CI: -0.17, 1.84, p = 0.10); HDL-LpPLA2 activity (fibrate vs. active control
= WMD: 0.77 nmol/ml/min, 95% CI: -0.33, 1.88, p = 0.17); and secretory PLA2 (fibrate vs. active control
= WMD: 0.37 ng/ml, 95% CI: -1.22, 1.97, p = 0.65). Also, the results of the sensitivity analysis were robust
for all these parameters.Conclusion:In conclusion, fibrate therapy did not reduce the mass and activity of Lp-PLA2.