title: Effects of two types of fish oil supplements on serum lipids and plasma phospholipid fatty acids in coronary artery disease.
abstract: Fish oil has consistently been shown to lower triglyceride levels, but its effects on low-density lipoprotein (LDL) cholesterol remain controversial. The current study compares the long-term effects of 2 different fish oil preparations (ethyl ester and triglyceride) versus olive oil in patients with coronary artery disease. Eighty-nine subjects were randomly assigned to receive capsules containing 6 g/day (triglyceride group) or 7 g/day (ethyl ester group) of n-3 fatty acids, or capsules containing 12 g/day of olive oil for 6 months. Mean triglyceride levels decreased by 28% in the ester and 32% in the triglyceride fish oil groups (p less than 0.05 for both). LDL cholesterol levels increased by 3% (difference not significant) in the ester and 12% (p less than 0.05) in the triglyceride fish oil groups; in hypertriglyceridemic subjects the increase was 23% (p less than 0.01) and 14% (difference not significant), respectively. Plasma phospholipid fatty acid analysis showed a fivefold increase in eicosapentaenoic acid levels in both fish oil groups (p less than 0.001), and a long-term decrease in arachidonic acid levels (p less than 0.001). Achieved eicosapentaenoic acid level correlated with the degree of increase in LDL cholesterol (r = 0.38, p less than 0.05). These data suggest that fish oil administration is associated with an increase in LDL cholesterol levels in a diverse group of patients with coronary artery disease; this change appears to be correlated with n-3 fatty acid absorption. The impact of this increase in LDL is unknown, but should be considered as potentially adverse.
authors.affiliation: Charles A. Dana Research Institute, Boston, Massachusetts.
authors.forename: G J
authors.initials: GJ
authors.lastname: Reis
authors.forename: D I
authors.initials: DI
authors.lastname: Silverman
authors.forename: T M
authors.initials: TM
authors.lastname: Boucher
authors.forename: M E
authors.initials: ME
authors.lastname: Sipperly
authors.forename: G L
authors.initials: GL
authors.lastname: Horowitz
authors.forename: F M
authors.initials: FM
authors.lastname: Sacks
authors.forename: R C
authors.initials: RC
authors.lastname: Pasternak
mesh_terms: D003327:Coronary Disease / Q000097:blood* / Q000178:diet therapy; D004042:Dietary Fats, Unsaturated / Q000627:therapeutic use; D004311:Double-Blind Method; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005231:Fatty Acids, Unsaturated / Q000097:blood* / Q000627:therapeutic use*; D005395:Fish Oils / Q000627:therapeutic use*; D006801:Humans; D008055:Lipids / Q000097:blood*; D000069463:Olive Oil; D010938:Plant Oils / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D004042:Dietary Fats, Unsaturated; D015525:Fatty Acids, Omega-3; D005231:Fatty Acids, Unsaturated; D005395:Fish Oils; D008055:Lipids; D000069463:Olive Oil; D010938:Plant Oils; C056974:SuperEPA; C060580:Promega