Oméga-3:
faits - thérapeutique et posologie
Valeurs
augmentées pour les lipides sanguins: env. 4g/jour EPA
et DHA
Les journaux spécialisés ont consacré
aux oméga-3 les articles suivants. La liste de ces publications
a été établie en avril 2003 et n'aspire nullement
à l'exhaustivité. Source: MEDLINE.
Ces données servent de référence pour les
médecins et les thérapeutes, de sorte à déterminer
la dose thérapeutique dans le cadre de l'hypercholestérolémie
ou de l'hyperlipoprotéinémie.
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n-3
polyunsaturated fatty acids and cardiovascular diseases.
Nordøy A: Department of Medicine, University of Tromsø,
Norway; Marchioli R, Arnesen H, Videbaek J
Lipids 2001 36 Suppl:S127-9
Abstract
An expert round table discussion on the relationship between intake
of n-3 polyunsaturated fatty acids (PUFA) mainly of marine sources
and coronary heart disease at the 34th Annual Scientific Meeting
of European Society for Clinical Investigation came to the following
conclusions: 1. Consumption of 1-2 fish meals/wk is
associated with reduced coronary heart disease (CHD) mortality.
2. Patients who have experienced myocardial infarction have decreased
risk of total, cardiovascular, coronary, and sudden death by drug
treatment with 1 g/d of ethylesters of n-3 PUFA, mainly as eicosapentaenoic
acid (EPA) and docosahexaenoic acid (DHA). The effect is present
irrespective of high or low traditional fish intake or simultaneous
intake of other drugs for secondary CHD prevention. n-3 PUFA may
also be given as fatty fish or triglyceride concentrates. 3. Patients
who have experienced coronary artery bypass surgery with venous
grafts may reduce graft occlusion rates by administration of 4
g/d of n-3 PUFA. 4. Patients with moderate
hypertension may reduce blood pressure by administration of 4
g/d of n-3 PUFA. 5. After heart transplantation,
4 g/d of n-3 PUFA may protect against development of hypertension.
6. Patients with dyslipidemia and or postprandial hyperlipemia
may reduce their coronary risk profile by administration of 1-4
g/d of marine n-3 PUFA. The combination with statins seems to
be a potent alternative in these patients. 7. There is growing
evidence that daily intake of up to 1 energy% of nutrients from
plant n-3 PUFA (alpha-linolenic acid) may decrease the risk for
myocardial infarction and death in patients with CHD. This paper
summarizes the conclusions of an expert panel on the relationship
between n-3 PUFA and CHD. The objectives for the experts were
to formulate scientifically sound conclusions on the effects of
fish in the diet and the administration of marine n-3 PUFA, mainly
eicosapentaenoic acid (EPA, 20:5n-3) and docosahexaenoic acid
(DHA, 22:6n-3), and eventually of plant n-3 PUFA, alpha-linolenic
acid (ALA, 18:3n-3), on primary and secondary prevention of CHD.
Fish in the diet should be considered as part of a healthy diet
low in saturated fats for everybody, whereas additional administration
of n-3 PUFA concentrates could be given to specific groups of
patients. This workshop was organized on the basis of questions
sent to the participants beforehand, on brief introductions by
the participants, and finally on discussion and analysis by a
group of approximately 40 international scientists in the fields
of nutrition, cardiology, epidemiology, lipidology, and thrombosis.
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Effect
of a fish-oil concentrate on serum lipids in postmenopausal women
receiving and not receiving hormone replacement therapy in a placebo-controlled,
double-blind trial.
Stark KD: Department of Human Biology
and Nutritional Sciences, University of Guelph, Canada; Park EJ,
Maines VA, Holub BJ
Am J Clin Nutr 2000 Aug 72:389-94
Abstract
BACKGROUND: n-3 Fatty acid supplementation lowered serum
triacylglycerol concentrations in studies in which most of the
subjects were male. The effects of n-3 fatty acid supplementation
in postmenopausal women receiving and not receiving hormone replacement
therapy (HRT) have received little attention. OBJECTIVE: We sought
to determine the effects of a fish-oil-derived n-3 fatty acid
concentrate on serum lipid and lipoprotein risk factors for cardiovascular
disease in postmenopausal women receiving and not receiving HRT,
with an emphasis on serum triacylglycerol concentrations and the
ratio of triacylglycerol to HDL cholesterol. DESIGN:
Postmenopausal women (n = 36) were grouped according
to exogenous hormone use and were randomly allocated to receive
8 capsules/d of either placebo oil (control) or n-3 fatty acid-enriched
oil (supplement). The supplement provided
2.4 g eicosapentaenoic acid (EPA) plus 1.6 g docosahexaenoic acid
(DHA) daily. Serum lipids and the fatty acid composition
of serum phospholipids were determined on days
0 and 28. RESULTS: Supplementation
with n-3 fatty acids was associated with 26% lower serum triacylglycerol
concentrations (P < 0.0001), a 28% lower overall ratio of serum
triacylglycerol to HDL cholesterol (P < 0.01), and
markedly greater EPA and DHA concentrations in serum phospholipids
(P < 0.05). CONCLUSIONS: These results show that supplementation
with a fish-oil-derived concentrate can favorably influence selected
cardiovascular disease risk factors, particularly by achieving
marked reductions in serum triacylglycerol concentrations and
triacylglycerol:HDL cholesterol in postmenopausal women receiving
and not receiving HRT. This approach
could potentially reduce the risk of coronary heart disease by
27% in postmenopausal women.
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Effects
of fish oil concentrate on lipoproteins and apolipoproteins in
familial combined hyperlipidemia.
Tat F: Medizinische Poliklinik, Universität
München; Keller C, Wolfram G
Clin Investig 1993 Apr 71:314-8
Abstract
The effects of two moderate doses of long-chain n-3
fatty acids (3.0 and 4.5 g EPA+DHA per day for 4 weeks each)
on serum lipids and lipoproteins of patients
with familial combined hyperlipidemia (FCH) were studied
in a double-blind, placebo-controlled clinical trial. In nine
patients with FCH n-3 fatty acids led to a statistically
significant, dose-dependent fall in very low density lipoprotein
(VLDL) triglycerides (3 g/day: -42%, 4.5 g/day: -55%) VLDL cholesterol
(3 g/day: -41%, 4.5 g/day: -47%), and VLDL apolipoprotein (apo)
B-100 (3 g/day: -40%, 4.5 g/day: -56%). No overall
change in low-density lipoprotein (LDL) cholesterol was found,
as confirmed statistically. However, when analyzing the data of
single patients LDL cholesterol and LDL apo B did not change in
five patients but increased dose dependently (from pretreatment
4.80 +/- 0.93 mmol/l to 5.70 +/- 0.93 mmol/l LDL cholesterol after
4.5 g/day) in four. LDL and VLDL composition as indicated by cholesterol/apo
B-100 and triglyceride/apo B-100 ratios did not change significantly.
High-density lipoprotein (HDL) cholesterol was unchanged; the
HDL cholesterol/apo A-I+apo A-II ratio increased by 19% (P <
0.05) during fish oil treatment. We conclude
that in FCH moderate doses of long-chain n-3 fatty acids are highly
effective in lowering pathological VLDL triglycerides, VLDL cholesterol,
and VLDL apo B. LDL cholesterol must, however, be monitored
during treatment as it may rise substantially in some although
not in all patients with this disease.
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Small
supplements of N-3 fatty acids change serum low density lipoprotein
composition by decreasing phospholid and apolipoprotein B concentrations
in young adult women.
Sanchez-Muniz FJ: Departmento de Nutricion
y Bromatologia I, Facultad de Farmacia, Universidad Complutense,
Madrid, Spain; Bastida S, Viejo JM, Terpstra AH
Eur J Nutr 1999 Feb 38:20-7
Abstract
In order to investigate the effect of a short-term application
of marine n-3 polyunsaturated fatty acids on the composition of
serum very low density lipoproteins (VLDL), low density lipoproteins
(LDL), and high density lipoproteins (HDL),
nine women aged 29 +/- 4.2 years, following a diet
with a SFA/MUFA/PUFA profile of 2.4/3/1, received supplements
of six capsules daily, each
capsule containing 0.137 g of n-3 fatty
acids (14.5% eicosapentaenoic acid (EPA) and 8.9% docosahexaenoic
acid (DHA)) for 10 d. Food consumption, assessed during
two 10-days periods indicates that percentage contribution of
SFA, MUFA, and PUFA to the daily energy intake did not change
through the fish-oil supplementation period, but the daily consumption
of n-3 fatty acids increased 2.3 times. N-3 fatty supplementation
increased EPA and DHA percentages in serum phospholipids, but
failed to decrease (p > 0.05) the cholesterol and triglyceride
concentration in serum LDL and HDL, although it did so in VLDL.
In contrast, the lipoprotein-phospholipid
and lipoprotein-protein concentrations were markedly affected,
mainly in LDL and HDL (at least p < 0.01). HDL and
VLDL compositions were not affected but
the total mass (lipid + protein in mg/dl) concentration of these
lipoproteins significantly decreased (p < 0.05), suggesting
a lower number of these particles in circulating blood after the
n-3 treatment. The LDL-cholesterol/LDL-apolipoprotein
B ratio increased (p < 0.01) reflecting a probable increase
in LDL size. Following fish oil supplementation,
LDL particles contained a significantly lower amount of phospholipids,
which also suggests changes in the surface/core ratio of the average
LDL. Changes in serum lipoprotein lipids did not significantly
correlate with any dietary change other than the n-3 fatty acid
increase. The results indicate that a
10-day application of a small supplement of n-3 change the LDL
composition leading to less atherogenic LDL particles with lower
phospholipid and apolipoprotein (Apo) B concentrations.
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The
effect of n-3 fatty acid administration on selected indicators
of cardiovascular disease risk in patients with type 2 diabetes
mellitus.
Habán P: Klinické oddelenie
Výskumného ústavu výzivy v Bratislave;
Simoncic R, Klvanová I, Ozdín L, Zideková
E
Bratisl Lek Listy 1998 Jan 99:37-42
Abstract
BACKGROUND: Serum triacylglycerols (TG), VLDL, HDL, fatty
acid and eicosanoid spectrum are among the factors determining
the risk of cardiovascular complications in NIDDM. N-3 polyunsaturated
fatty acids (PUFA) are expected to have beneficial effects on
these factors. In NIDDM patients there have however been previously
reported (late 1980s) some adverse effects. OBJECTIVES: Our aim
was to verify the effects of n-3 PUFA in NIDDM patients using
relatively low dosage. METHODS: The investigated
group included 21 NIDDM patients with dyslipoproteinemia type
IV. The patients were treated for 28 days with 1.7 g EPA (eicosapentaenoic
acid) + 1.15 g DHA (docosahexaenoic acid)/day (10 capsules/day
of MAXEPA, Seven Seas U.K.). The lipoproteins were measured using
the BIO-LACHEMA kits, the fatty acid spectrum in phospholipids
was determined by gas chromatography and prostanoids (after their
separation) were measured by RIA methods. MAIN RESULTS AND CONCLUSIONS:
After the MAXEPA treatment there has
been a strong decrease in TG (p < 0.005) and VLDL (p < 0.002)
serum levels, accompanied by a significant increase in HDL (p
< 0.02). The final-to-baseline TG ratio in individual
patients negatively correlated with the relative percentage of
EPA in phospholipids after the treatment (p < 0.03; r = -0.474).
There was no significant change in serum total cholesterol, fasting
glycaemia and glycosylated hemoglobin. There was a slight, but
statistically already significant (p < 0.05), rise in LDL.
The relative percentage of EPA, docosapentaenoic acid and DHA
in serum phospholipids increased sharply (p < 0.001, p <
0.001, p < 0.001). The increase of
n-3 PUFA in individual patients was linked with the decrease in
n-6 PUFA (p < 0.001; r = -0.686). The spectrum of
the latter has changed also very markedly. The
prostacyclin PGI2-to-thromboxane TxA2 ratio increased significantly
(p < 0.001). Beneficial effects of n-3 fatty acids
have prevailed and this kind of treatment seems very encouraging
also in NIDDM patients. The results are logically compatible with
other authors' results pattern formed in 1990s. A slight rise
in serum LDL needs a more detailed discussion since only its phenotype
B ("small dense LDL particles") has been recently found to be
atherogenic. (Tab. 2, Fig. 5, Ref. 15.)
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Effects
of supplementation with fish oil-derived n-3 fatty acids and gamma-linolenic
acid on circulating plasma lipids and fatty acid profiles in women.
Laidlaw M: Department of Human Biology
and Nutritional Sciences, University of Guelph, Canada; Holub BJ
Am J Clin Nutr 2003 Jan 77:37-42
Abstract
BACKGROUND: Eicosapentaenoic acid (EPA), docosahexaenoic
acid (DHA), and gamma-linolenic acid (GLA) have lipid-modifying
and antiinflammatory properties. The effects of supplement mixtures
of these fatty acids on plasma lipids and the fatty acid compositions
of serum phospholipids have received little attention. OBJECTIVE:
The objective was to determine the effects of different levels
of GLA supplementation together with a constant intake of EPA
plus DHA on the triacylglycerol-lowering effect of EPA plus DHA
alone and on the fatty acid patterns (eicosanoid precursors) of
serum phospholipids. DESIGN: Thirty-one
women were assigned to 1 of 4 groups, equalized on
the basis of their fasting triacylglycerol concentrations. They
received supplements providing 4 g EPA+DHA
(4:0, EPA+DHA:GLA; control group), 4 g EPA+DHA plus 1 g GLA (4:1),
2 g GLA (4:2), or 4 g GLA (4:4) daily for 28 d. Plasma
lipids and fatty acids of serum phospholipids were measured on
days 0 and 28. RESULTS: Plasma triacylglycerol concentrations
were significantly lower on day 28 than on day 0 in the 4:0, 4:1,
and 4:2 groups. LDL cholesterol decreased significantly (by 11.3%)
in the 4:2 group. Dihomo-gamma-linolenic acid increased significantly
in serum phospholipids only in the 4:2 and 4:4 groups; however,
total n-3 fatty acids increased in all 4 groups. CONCLUSIONS:
A mixture of 4 g EPA+DHA and 2 g GLA
favorably altered blood lipid and fatty acid profiles in healthy
women. On the basis of calculated PROCAM values, the
4:2 group was estimated to have a 43% reduction in the 10-y risk
of myocardial infarction.
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Effects
of purified eicosapentaenoic and docosahexaenoic acids on glycemic
control, blood pressure, and serum lipids in type 2 diabetic patients
with treated hypertension.
Woodman RJ: Department of Medicine,
The University of Western Australia, Perth, Australia; Mori TA,
Burke V, Puddey IB, Watts GF, Beilin LJ
Am J Clin Nutr 2002 Nov 76:1007-15
Abstract
BACKGROUND: n-3 Fatty acids lower blood pressure, improve
lipids, and benefit other cardiovascular disease risk factors.
Effects on glycemia in patients with type 2 diabetes are uncertain.
OBJECTIVE: We determined whether purified eicosapentaenoic acid
(EPA) and docosahexaenoic acid (DHA) have differential effects
on glycemic control, including insulin sensitivity and stimulated
insulin secretion; 24-h ambulatory blood pressure; and serum lipids
in type 2 diabetic patients with treated hypertension. DESIGN:
In a double-blind, placebo-controlled trial of parallel design,
59 subjects were randomly assigned to
consume 4 g EPA, DHA, or olive oil/d for 6 wk while
continuing to consume their usual diet. RESULTS: Thirty-nine
men and 12 postmenopausal women with a mean (+/- SE) age of 61.2
+/- 1.2 y completed the study. In comparison with the
change from baseline in fasting glucose in the olive oil group,
fasting glucose in the EPA and DHA groups increased 1.40 +/- 0.29
mmol/L (P = 0.002) and 0.98 +/- 0.29 mmol/L (P = 0.002), respectively.
Neither EPA nor DHA had significant effects on glycated hemoglobin,
fasting insulin or C-peptide, insulin sensitivity or secretion,
or blood pressure. Serum triacylglycerols
in the EPA and DHA groups decreased 19% (P = 0.022) and 15% (P
= 0.022), respectively. There were no significant changes
in serum total, LDL, or HDL cholesterol, although HDL(2)
cholesterol in the EPA and DHA groups increased 16% (P = 0.026)
and 12% (P = 0.05), respectively. HDL(3) cholesterol decreased
11% (P = 0.026) with EPA supplementation. CONCLUSIONS:
EPA and DHA had similar benefits on lipids but adverse effects
on short-term glycemic control in hypertensive diabetic patients.
The overall implications for cardiovascular disease require long-term
evaluation.
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The
effect of omega-3 fatty acids on risk factors for cardiovascular
diseases.
Yam D: Weizmann Institute of Science,
Givatayim, Israel; Bott-Kanner G, Genin I, Shinitzky M,
Klainman E
Harefuah 2001 Dec 140:1156-8, 1230
Abstract
Cardiovascular disease (CVD) is associated with dyslipidemia
and frequently with insulin resistance, both of which are in general
no alleviated by antilipidemic drugs. Our objective was to examine
whether a dietary supplement containing omega-3 fatty acids (n-3
FA) can reduce the levels of serum lipids, fasting insulin and
glucose in documented CVD patients treated by statins or bezafibrates.
In a double-blind placebo-controlled trial of parallel design,
52 patients, age 69.2 years +/- 3.6
treated by antilipidemic drugs, were randomly assigned
to receive daily 7 gr of a dietary concentrated
supplement containing 67% n-3 FA (185 mg EPA and 465 mg/g DHA)
in a form of spread (Yamega Ltd, Israel) or olive oil spread (placebo)
and recommended to reduce the consumption of omega-6 fatty acids
for 12 weeks. The average values +/- SD before and after dietary
supplementations were compared. RESULTS:
44 patients (23 in the n-3 FA group) completed the study. In
the n-3FA group we observed a significant decrease (p < 0.05)
of total cholesterol (12.2%), LDL-cholesterol (16.8%),
triglycerides (36.1%), insulin in hyperinsulinemic subjects (>
20 microunits/ml) (34.9%), and no significant changes
in HDL-cholesterol and glucose. No hyperglycemia was detected.
In the olive oil group we observed a significant decrease (p <
0.05) in the LDL-cholesterol values of 15.5% and no significant
changes in the other parameters. No side effects were reported
during the study in any of the participants. Our findings demonstrate
that the incorporation of the dietary
supplement containing EPA and DHA omega-3 fatty acids reduces
significantly the above risk factors for CVD.
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Study
of the effects of dietary fish intake on serum lipids and lipoproteins
in two populations with different dietary habits.
Torres IC: Departamento de Quamica,
Universidade da Madeira, Funchal, Portugal; Mira L, Ornelas CP,
Melim A
Br J Nutr 2000 Apr 83:371-9
Abstract
Increased concentrations of n-3 polyunsaturated
fatty acids (PUFA), namely eicosapentaenoic acid (20:5; EPA) and
docosahexaenoic acid (22:6; DHA), have been shown to be beneficial
in coronary artery disease (CAD). In the present study, the relationships
between fish intake and concentrations of serum EPA and DHA and
the effects of these fatty acids on serum lipids and lipoproteins
were investigated. Two groups of men, one living in a fishing
village and the other in a farming village, participated in this
study. The daily fish consumption was ten times greater in the
fishing village group than in the rural village group and the
mortality from IHD in the rural village was four times higher.
Serum concentrations of EPA and DHA were significantly higher
in the fishing village group (P < 0.001). In this group, the
serum concentration of arachidonic acid (20:4; AA), was significantly
lower (P < 0.001), and the ratio EPA:AA was twice that of the
rural village (P < 0.001). Moreover, in the fishing village
group, the serum triacylglycerol and total cholesterol levels
were significantly lower than those observed in the rural village
(P < 0.01 and P < 0.05 respectively). In the fishing village
group the serum LDL-cholesterol concentration was also lower,
although the difference was not significant.
Our results reinforce the hypothesis that a high intake
of n-3 PUFA provides protection against CAD.
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The
effect of dietary enrichment with fish-oil on urinary excretion
of N-acetyl-beta-D-glucosaminidase and renal function in proteinuric
patients with primary glomerulopathies.
Manitius J: Department of Nephrology,
Medical University of Gdansk, Poland; Sulikowska B, Fox J,
Jakubowski Z, Ludwiczak E, Lysiak-Szydakowska W,
Rutkowski B
Int Urol Nephrol 1997 29:489-95
Abstract
The rate of progression of renal disease depends on many
factors including serum lipids and tubulo-interstitial injury. Aim
of the study was to see whether fish-oil therapy may affect serum
lipids and NAG excretion with urine (a marker of tubular cell damage)
in humans with renal disease. The effects of dietary fish-oil fatty
acids on the serum lipids, NAG urinary excretion and serum arachidonic
acid concentration were examined in thirteen primary glomerulonephritic
patients with proteinuria and normal renal function. The regular
diet enriched with 1650 mg n-3 polyunsaturated fatty acids (18%:
20:5; n-3 EPA and 12%: 22:5; n-3 DHA) was ingested for three months.
At the end of fish-oil enriched diet neither creatinine clearance
nor urinary protein excretion changed significantly. But serum concentration
of HDL and arachidonic acid increased (48.0 +/- 15 vs. 52.0 +/-
14; p < 0.05), (0.47 +/- 0.13 vs. 0.72 +/- 0.29; p < 0.01),
respectively. Simultaneously urine NAG excretion and serum LDL decreased
(11.2 +/- 7.1 vs. 10.3 +/- 7.3; p < 0.05), (163.0 +/- 57 vs.
149.0 +/- 51, p < 0.01), respectively. We presume that fish-oil
supplementation may have a beneficial effect on renal tubular cells
in humans and it could be linked with arachidonic acid metabolism.
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Habitual
fish consumption, plasma phospholipid fatty acids, and serum lipids:
the Tromsø study.
Bønaa KH: Institute of Community Medicine, University of
Tromsø, Norway; Bjerve KS, Nordøy A
Am J Clin Nutr 1992 Jun 55:1126-34
Abstract
We examined the cross-sectional relationships between the
frequency of habitual fish consumption, plasma phospholipid fatty
acids, and serum lipids and lipoproteins in 152 men and women. There
was a significant association between fish consumption starting
from 1 dish/wk and plasma n-3, n-6, and n-9 fatty acids. Plasma
eicosapentaenoic acid (EPA; 20: 5n-3) reflected fish consumption
to a greater extent than did docosahexaenoic acid (DHA;22:6n-3).
Triglycerides decreased (P less than 0.05) with fish consumption.
In multivariate analysis in which anthropometric and lifestyle factors
were controlled for, EPA correlated inversely with triglycerides
(P less than 0.05) and positively with high-density-lipoprotein
(HDL) cholesterol and apolipoprotein A-I (both P less than 0.001).
In contrast, DHA did not correlate with triglycerides and showed
negative associations to HDL cholesterol and apolipoprotein A-I
(both P less than 0.001). Platelet phospholipid EPA, but not DHA,
was associated with lower triglyceride and higher HDL-cholesterol
concentrations (both P less than 0.05). This study suggests that
long-term intake of small amounts of fish has biological effects,
and that EPA and DHA have divergent relations with lipoprotein metabolism. |
Purified
eicosapentaenoic and docosahexaenoic acids have differential effects
on serum lipids and lipoproteins, LDL particle size, glucose, and
insulin in mildly hyperlipidemic men.
Mori TA: Department of Medicine, The
University of Western Australia and The West Australian Heart Research
Institute, Perth; Burke V, Puddey IB, Watts GF, O'Neal DN,
Best JD, Beilin LJ
Am J Clin Nutr 2000 May 71:1085-94
Abstract
BACKGROUND: Regular consumption of n-3 fatty acids of marine
origin can improve serum lipids and reduce cardiovascular risk.
OBJECTIVE: This study aimed to determine whether eicosapentaenoic
(EPA) and docosahexaenoic (DHA) acids have differential effects
on serum lipids and lipoproteins, glucose, and insulin in humans.
DESIGN: In a double-blind, placebo-controlled trial of parallel
design, 59 overweight, nonsmoking, mildly
hyperlipidemic men were randomly assigned to receive 4 g purified
EPA, DHA, or olive oil (placebo) daily while continuing
their usual diets for 6 wk.
RESULTS: Fifty-six men aged 48.8 +/- 1.1
y completed the study. Relative to those in the olive
oil group, triacylglycerols fell by 0.45
+/- 0.15 mmol/L ( approximately 20%; P = 0.003) in the DHA group
and by 0.37 +/- 0.14 mmol/L ( approximately 18%; P = 0.012) in the
EPA group. Neither EPA nor DHA had any effect on total
cholesterol. LDL, HDL, and HDL(2) cholesterol were not affected
significantly by EPA, but HDL(3) cholesterol
decreased significantly (6.7%; P = 0.032). Although HDL
cholesterol was not significantly increased by DHA (3. 1%), HDL(2)
cholesterol increased by approximately 29% (P = 0.004). DHA increased
LDL cholesterol by 8% (P = 0.019). Adjusted LDL particle size increased
by 0.25 +/- 0.08 nm (P = 0.002) with DHA but not with EPA. EPA supplementation
increased plasma and platelet phospholipid EPA but reduced DHA.
DHA supplementation increased DHA and EPA in plasma and platelet
phospholipids. Both EPA and DHA increased fasting insulin significantly.
EPA, but not DHA, tended to increase fasting glucose, but not significantly
so. CONCLUSIONS: EPA and DHA had differential
effects on lipids, fatty acids, and glucose metabolism in overweight
men with mild hyperlipidemia. |
Heterogeneous
responsiveness of normolipemic women to n-3 long chain fatty acid
supplementation. Changes in serum lipids and apoproteins.
Sanchez-Muniz FJ: Departamento de Nutricion,
Facultad de Farmacia, Universidad Complutense, Madrid, Spain; Bastida S,
Quintas E, Merinero MC, Rodriguez-Gil S
Rev Esp Fisiol 1997 Dec 53:349-54
Abstract
The effect of 10 day-low dosage of n-3 long chain fatty acids
(390 mg/day of EPA and 252 mg/day of DHA) on lipid and apolipoprotein
(Apo) concentrations has been studied in nine normolipidaemic
women aged 28.9 +/- 4.2 years. n-3 fatty acid supplementation
did not significantly decrease total cholesterol and triglyceride
levels but markedly decreased the Apo A1 and Apo B concentrations
(12.7%, p < 0.01 and 23.1%, p < 0.001, respectively), while
the Apo A1/Apo B ratio significantly increased (14.8%, p < 0.02).
In contrast to the individual variations found for triglycerides
and cholesterol, Apo changes indicate a fairly homogeneous response
to the fish oil supplement. In seven women Apo A1 decreased (>
10%), whereas Apo B decreased (> 10%) in all of them. The Apo
A1/Apo B ratio increased (> 10%) in five of these nine women.
Changes in Apo A-1 and Apo B did not significantly correlate with
changes in serum lipids. These findings
suggest that short-term supplementation with low amount of n-3 long
chain fatty acids, EPA and DHA, influences the serum Apo content
more than the lipid levels in normolipidaemic women. |
Repeated
fasting and refeeding with 20:5, n-3 eicosapentaenoic acid (EPA):
a novel approach for rapid fatty acid exchange and its effect on
blood pressure, plasma lipids and hemostasis.
Yosefy C: WHO Collaborative Centre for
Prevention of Cardiovascular Diseases, Barzilai Medical Center,
Ashkelon, Ben Gurion University of the Negev, Beer-Sheva, Israel;
Viskoper JR, Varon D, Ilan Z, Pilpel D, Lugassy G,
Schneider R, Savyon N, Adan Y, Raz A
J Hum Hypertens 1996 Sep 10 Suppl 3:S135-9
Abstract
Twenty hypertensive
subjects participated in three clinical trials of 13 days each,
to examine the effects of Alsepa fish oil [20:5, n-3 eicosapentaenoic
acid (EPA) 180 mg, and 22:6 n-3 docosahexaenoic acid (DHA) 120 mg]
on n-3 for n-6 polyunsaturated fatty acids (PUFA) exchange on serum
phospholipids, blood pressure (BP), triglycerides (TG) and primary
hemostasis. After 13 days, plasma phospholipids showed an increase
in sigma n-3 (EPA and DHA) from 2.0 to 5.9% (P < 0.01), and a
decrease in sigma n-6 (arachidonic acid and linoleic acid) from
29.8 to 22.6% (P < 0.01). A concomitantly
significant reduction in systolic BP (SBP) (158.7 +/- 23.8 mm Hg
to 146.5 +/- 17.0 mm Hg, P = 0.04), and diastolic BP (DBP) (80.8
+/- 8.4 mm Hg to 72.9 +/- 14.9 mm Hg, P = 0.04) as well as a significant
decrease in platelet adhesion and aggregation on extra cellular
matrix measured as a percentage of surface coverage (11.9 +/- 4.8%
to 4.2 +/- 3.2%, P = 0.0001) was observed. In addition,
a significant reduction in baseline dependent TG was observed; the
higher the baseline level TG, the more pronounced the reduction
(average 159.2 +/- 74.6 mg% to 108.0 +/- 46.1 mg%, P = 0.001). No
change was observed in total cholesterol, high and low density lipoprotein
(HDL, LDL), platelet and fibrinogen. Repeated fasting and refeeding
with fish oil facilitated plasma exchange of n-3 for n-6 PUFA, improved
BP, clinical metabolic parameters and lowered platelet reactivity
in the vessel wall (primary hemostasis). In severe and life-threatening
situations, the beneficial effects of fish
oil should be considered for rapid exchange of n-3 for n-6 PUFA.
In this study we describe a novel approach for rapid fatty acid
exchange by fasting/refeeding with fish oil supplementation, as
well as improved BP, plasma lipids and primary hemostasis. Further
research is required on the therapeutic use of fish oils and the
physiological mechanisms involved in fatty acid exchange.
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Influence
of a concentrated ethylester compound of n-3 fatty acids on lipids,
platelets and coagulation in patients undergoing coronary bypass
surgery.
Nilsen DW: Dept. of Medicine, University
of Tromsö, Norway; Dalaker K, Nordaa A, Os
Thromb Haemost 1991 Aug 66:195-201
Abstract
Twenty patients
accepted for coronary bypass surgery were randomized
to receive either a concentrated ethylester compound of n-3 fatty
acids, with a daily dose of 3.15 g of
eicosapentaenoic acid (EPA) and 1.89 g of docosahexaenoic acid
(DHA), or corn oil (controls) in a double blind study,
to evaluate the effect on lipids, platelets and coagulation during
the pre- and postoperative phase. Only patients with fasting
triglyceride (TG) levels greater than or equal to 1.6 mmol/l at
recruitment were eligible. The study was continued for 5
to 6 months. Surgery was usually performed at mid-intervention.
Blood samples were collected during morning hours in fasting subjects,
just prior to intervention, preoperatively and at final postoperative
follow-up. Moreover, blood loss was accurately accounted for postoperatively.
A threefold increase (p = 0.0001) of EPA was noted at pre-
and postoperative follow-up. TG-levels
were reduced 20 and 39%, respectively, in patients on n-3 fatty
acids, reaching statistical significance at end of intervention
(p = 0.034). TG-levels in controls remained largely
unchanged. In patients on n-3 fatty acids, there was a statistically
significant increase in serum total cholesterol preoperatively,
but this change was no longer present at completion of the study.
No significant changes were noted in platelet function, as judged
by bleeding time, collagen induced platelet aggregation and release
of TxB2 during aggregation. Parameters of extrinsic coagulation,
including phospholipase C-sensitive factor VII (PLC-VII) and extrinsic
pathway inhibitor (EPI), also remained essentially unchanged in
both groups of patients. However, fibrinogen was significantly
reduced in controls (p less than 0.05) at end of intervention
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