title: Clinical overview of algal-docosahexaenoic acid: effects on triglyceride levels and other cardiovascular risk factors.
abstract: The cardiovascular benefits of fish-derived long-chain polyunsaturated fatty acids, docosahexaenoic acid (DHA), and eicosapentaenoic acid are well established. Less studied are specific effects of individual long-chain polyunsaturated fatty acids. Based on data from 16 published clinical trials, this review examines effects of DHA triglyceride (TG) oil derived from algae (algal-DHA) on serum TG levels and related parameters. Study populations included subjects with both normal and elevated TG levels including those with persistent hypertriglyceridemia treated with concomitant 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) therapy. At doses of 1-2 g/d, algal-DHA significantly lowered plasma TG levels (up to 26%) either administered alone or in combination with statins. The reduction in TG levels was markedly greater in hypertriglyceridemic than in normal subjects. Algal-DHA modestly increased plasma levels of both high-density lipoprotein and low-density lipoprotein cholesterol. The increased plasma level of low-density lipoprotein cholesterol was associated with a shift of lipoprotein particle size toward larger, less atherogenic subfractions. In some subjects, blood pressure and heart rate were significantly reduced. Algal-DHA was safe and well tolerated. Unlike fish oil, algal-DHA seldom caused gastrointestinal complaints such as fishy taste and eructation, attributes of importance for patient compliance in high-dose therapy. Regression analysis that showed a linear relationship between baseline TG and magnitude of TG reduction suggests that a study of patients with very high TG levels (>500 mg/dL) is warranted. Future pharmacologic therapies for treating hypertriglyceridemia may include algal-DHA.
authors.affiliation: Martek Biosciences Corporation, Columbia, MD 21045, USA. alryan@martek.com
authors.forename: Alan S
authors.initials: AS
authors.lastname: Ryan
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Keske
authors.forename: James P
authors.initials: JP
authors.lastname: Hoffman
authors.forename: Edward B
authors.initials: EB
authors.lastname: Nelson
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control; D002986:Clinical Trials as Topic; D004281:Docosahexaenoic Acids / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D056890:Eukaryota / Q000737:chemistry*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D015228:Hypertriglyceridemia / Q000188:drug therapy; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014280:Triglycerides; D004281:Docosahexaenoic Acids