The effect of fibrates on high density lipoprotein (HDL)-cholesterol levels is suggested to be mediated by its binding to peroxisome proliferator-activated receptor- (PPAR). Upon ligand binding, PPAR heterodimerizes with the 9-cis retinoic acid receptor (RXR), and the heterodimer regulates gene expression. We assessed the hypothesis that a dual treatment with fibrate plus 9-cis -carotene-rich powder of the alga Dunaliella bardawil, as a source of 9-cis retinoic acid, would improve the drug’s effect on HDL-cholesterol levels.

patients with plasma HDL-cholesterol levels below 40 mg/dl and triglyceride (TG) levels above 200 mg/dl after fibrate treatment (for at least 6 weeks). are given four capsules of Dunaliella, providing 60 mg -carotene/day. The all-trans to 9-cis -carotene ratio in the capsules is about 1:1.

Inclusion Criteria:

age 18-70 years Fibrate treatment (for at least 6 weeks) HDL-Cholesterol lower than 40mg/dl. Trigliceride over 150mg/dl. -

Exclusion Criteria:

High CPK. Elevated liver fanction. Active CHD. Smokers. Diabetes patients treated with Insullin or Avandia. HbA1C great than 8.5.

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