title: Effects of omega-3 polyunsaturated fatty acids on metabolically active hormones in patients post-myocardial infarction.
abstract: BACKGROUND
  Long-chain omega-3 polyunsaturated fatty acids (PUFA) supplementation is used as a therapeutic secondary prevention strategy among post-myocardial infarction (MI) patients. The effects of omega-3 PUFA on markers of energy homeostasis among post-MI patients are unclear.
  
  
  METHODS
  We investigated the effects of Omacor (a pharmaceutical capsule formulation of highly refined, concentrated omega-3 PUFA; Solvay Healthcare, Southampton, UK; 1 g/day) in addition to usual care (cardiovascular therapy) in a pilot randomised study of 35 post-MI men. Following randomisation to Omacor (n=16), or 'usual care' controls (n=19), fasting levels of insulin, non-esterified fatty acids (NEFA), triglycerides, glucose and adipocytokines (adiponectin, leptin and tumour necrosis factor (TNF)-alpha), as indices of markers of energy homeostasis, were measured at baseline and after 3-month treatment.
  
  
  RESULTS
  There were no baseline differences in age, body mass index, blood pressure, fasting triglycerides, plasma glucose, NEFA and adipocytokines between the two treatment arms (P=0.07). There were no significant changes in metabolically active hormones within groups after 3-month treatment. Across arms, the direction of baseline to follow-up changes in insulin levels were significantly different (P= 0.03), with a mean increase with Omacor (+3.39 mU/ml) and a decrease among controls (-17.6 mU/ml), without associated deteriorating changes in triglycerides, NEFA or plasma glucose.
  
  
  CONCLUSIONS
  This pilot study suggests that Omacor had little effect on glycaemic control among male post-MI patients. However, Omacor was associated with raised insulin levels, compared to usual care; thus, a metabolic basis for the cardioprotective action of Omacor, outside of its lipid lowering effects, merits further investigation.
authors.affiliation: Haemostasis Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham B18 7QH, UK.
authors.forename: Jeetesh V
authors.initials: JV
authors.lastname: Patel
authors.forename: Kaeng W
authors.initials: KW
authors.lastname: Lee
authors.forename: Joseph
authors.initials: J
authors.lastname: Tomson
authors.forename: Kiran
authors.initials: K
authors.lastname: Dubb
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Hughes
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
mesh_terms: D000368:Aged; D019587:Dietary Supplements; D004281:Docosahexaenoic Acids / Q000494:pharmacology*; D004338:Drug Combinations; D015118:Eicosapentaenoic Acid / Q000494:pharmacology*; D004734:Energy Metabolism / Q000187:drug effects*; D015525:Fatty Acids, Omega-3 / Q000494:pharmacology*; D006706:Homeostasis / Q000187:drug effects; D006728:Hormones / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism; D010865:Pilot Projects
chemical_list: D004338:Drug Combinations; D015525:Fatty Acids, Omega-3; D006728:Hormones; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid; C405603:Omacor