Effects of diet and simvastatin on fatty acid composition in hypercholesterolemic men: a randomized controlled trial.
OBJECTIVE
To explore the separate and combined effects of simvastatin and a low-saturated diet rich in alpha-linolenic acid on serum fatty acids.


RESULTS
120 hypercholesterolemic men were randomly allocated to a habitual diet or dietary treatment group and to receive, in random order, simvastatin 20 mg/d or placebo, each for 12 weeks, in a double-blind manner. Dietary treatment decreased proportions from total fatty acids of palmitic acid (C16:0) by 3.3% (P<0.05), stearic acid (C18:0) by 3.7% (P<0.05) and increased proportions of oleic acid (C18:1n-9) by 4.2% (P<0.01), and alpha-linolenic acid (C18:3n-3) by 29.8% (P<0.001). Simvastatin decreased proportions from total fatty acids of palmitic acid by 2.0% (P<0.01), linoleic acid (C18:2n-6) by 5.3% (P<0.001), and alpha-linolenic acid by 6.8% (P<0.05), and increased proportions of gamma-linolenic acid (C18:3n-6) by 11.1% (P<0.001), dihomo-gamma-linolenic acid (C20:3n-6) by 4.2% (P<0.01), arachidonic acid (C20:4n-6) by 14.2% (P<0.001), and the sum of long-chain polyunsaturated fatty acids (C20-22) by 9.0% (P<0.001). Simvastatin increased ratios of stearic to palmitic, gamma-linolenic to linoleic, and arachidonic to dihomo-gamma-linolenic acid by 7.6%, 17.0%, and 10.0% (P<0.001 for all), respectively, suggesting increased fatty acid elongase and Delta6- and Delta5-desaturase enzyme activities.


CONCLUSIONS
Increased formation of long-chain polyunsaturated fatty acids and their metabolites may contribute a substantial part of the pleiotropic effects of simvastatin.
Jula
Antti
A
Department of Health and Functional Capacity, National Public Health Institute of Finland, Turku, Finland. antti.jula@ktl.fi
Marniemi
Jukka
J
Rönnemaa
Tapani
T
Virtanen
Arja
A
Huupponen
Risto
R
D000328:Adult; D000924:Anticholesteremic Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D004041:Dietary Fats / Q000008:administration & dosage / Q000097:blood; D005227:Fatty Acids / Q000097:blood; D005231:Fatty Acids, Unsaturated / Q000097:blood; D005247:Feeding Behavior; D006801:Humans; D006937:Hypercholesterolemia / Q000178:diet therapy* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D019821:Simvastatin / Q000008:administration & dosage*; D016896:Treatment Outcome; D017962:alpha-Linolenic Acid / Q000008:administration & dosage* / Q000097:blood
D000924:Anticholesteremic Agents; D004041:Dietary Fats; D005227:Fatty Acids; D005231:Fatty Acids, Unsaturated; D017962:alpha-Linolenic Acid; D019821:Simvastatin