Omega-3 polyunsaturated fatty acid in peripheral arterial disease: effect on lipid pattern, disease severity, inflammation profile, and endothelial function.
OBJECTIVE
Peripheral arterial disease (PAD) is strongly associated with endothelial dysfunction and inflammation, which portend a high cardiovascular risk. Accordingly, we investigated the effects of omega-3 polyunsaturated fatty acid (n-3 PUFA) supplementation on endothelial function and inflammatory status in affected individuals.


METHODS
PAD patients were randomly divided into two groups. In Group I (n=16) pre-enrollment therapy was not modified, while in Group II (n=16) n-3 PUFAs 1 g b.i.d. for 3 months were added to the previous treatment. Endothelial function was assessed by measuring plasma soluble thrombomodulin (sTM) and brachial artery flow-mediated dilation (FMD), and the inflammatory status by measuring high-sensitivity C-reactive protein and myeloperoxidase.


RESULTS
In Group II, n-3 PUFAs reduced sTM levels from the median value of 33.0 ng/mL (interquartile range 16.7, 37.2) to 17.0 ng/mL (11.2, 33.7) (p=0.04), and improved FMD from 6.7% (3.7, 8.7) to 10.0% (6.2, 14.2) (p=0.02). Conversely, these markers did not change in Group I. After 3 months, the levels of inflammatory markers remained unmodified in both groups.


CONCLUSIONS
In PAD, n-3 PUFAs induced a marked improvement in endothelial function. Conversely, they did not affect the inflammatory status. In future, large, prospective studies are needed to investigate whether n-3 PUFAs, by improving endothelial function, would reduce the incidence of ischemic events in a population at high risk.
Schiano
Vittorio
V
Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University of Naples Federico II, Naples, Italy.
Laurenzano
Eugenio
E
Brevetti
Gregorio
G
De Maio
Julieta Isabel
JI
Lanero
Simona
S
Scopacasa
Francesco
F
Chiariello
Massimo
M
D000368:Aged; D015415:Biomarkers / Q000097:blood; D001783:Blood Flow Velocity; D001916:Brachial Artery / Q000187:drug effects / Q000502:physiology; D002097:C-Reactive Protein / Q000378:metabolism; D019587:Dietary Supplements; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000502:physiology; D015525:Fatty Acids, Omega-3 / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D009195:Peroxidase / Q000378:metabolism; D012039:Regional Blood Flow; D018570:Risk Assessment; D012720:Severity of Illness Index; D016037:Single-Blind Method; D018180:Thrombomodulin / Q000097:blood; D016896:Treatment Outcome
D015415:Biomarkers; D015525:Fatty Acids, Omega-3; D018180:Thrombomodulin; D002097:C-Reactive Protein; D009195:Peroxidase