True about fibrates is all except:
## Core Concept
Fibrates are a class of medications used to lower cholesterol levels and prevent cardiovascular disease. They work by activating **peroxisome proliferator-activated receptor-alpha (PPAR-alpha)**, which regulates the expression of genes involved in lipid metabolism. This activation leads to increased lipolysis and elimination of triglyceride-rich particles from the plasma.
## Why the Correct Answer is Right
The correct answer, although not explicitly provided, relates to understanding the properties and effects of fibrates. Fibrates are known to effectively reduce triglycerides and increase high-density lipoprotein (HDL) cholesterol. They are often used in patients with hypertriglyceridemia and mixed dyslipidemia. The mechanism through PPAR-alpha activation results in decreased apolipoprotein C-III (an inhibitor of lipoprotein lipase) and increased lipoprotein lipase, contributing to their therapeutic effects.
## Why Each Wrong Option is Incorrect
- **Option A:** Without the specific details of option A, we can infer that any statement about fibrates increasing the risk of myopathy or rhabdomyolysis, particularly when combined with statins, could be a correct association, making an incorrect statement about this risk profile potentially wrong.
- **Option B:** If option B mentions the use of fibrates in reducing cardiovascular events, this is a correct association. Fibrates have been shown to reduce cardiovascular events in certain populations, making an option denying this potentially incorrect.
- **Option C:** If option C discusses the effect of fibrates on lipid profiles, such as lowering triglycerides and raising HDL, a statement contradicting these well-established effects would be incorrect.
- **Option D:** This is marked as the correct answer but without specific details provided, we infer based on common knowledge about fibrates.
## Clinical Pearl / High-Yield Fact
A key point to remember is that fibrates can increase the risk of **myopathy and rhabdomyolysis**, especially when used in combination with statins. This risk necessitates careful monitoring of patients on these combinations.
## Correct Answer: D.