title: Significant differential effects of omega-3 fatty acids and fenofibrate in patients with hypertriglyceridemia.
abstract: BACKGROUND
  Omega-3 fatty acids and fenofibrate are both used to treat patients with hypertriglyceridemia. However, a head-to-head comparison of the lipoprotein and metabolic effects of these two medicines has not been published.
  
  
  METHODS
  This was a randomized, single-blind, placebo-controlled, parallel study. Age, sex, and body mass index were matched among groups. All patients were recommended to maintain a low fat diet. Fifty patients in each group were given placebo, omega-3 fatty acids 2 g (most commonly used dosage in Korean patients), or fenofibrate 160 mg, respectively daily for 2 months.
  
  
  RESULTS
  Omega-3 fatty acids therapy decreased triglycerides by 21% and triglycerides/HDL cholesterol and improved flow-mediated dilation (P<0.01), however, did not significantly change insulin, plasma adiponectin levels, and insulin sensitivity (determined by QUICKI) relative to baseline measurements. Fenofibrate therapy decreased total cholesterol, triglycerides by 29%, and triglycerides/HDL-cholesterol (all P<0.01) and improved flow-mediated dilation when compared with baseline. When compared with placebo and omega-3 fatty acids, fenofibrate therapy decreased non-HDL cholesterol (P<0.001) and triglycerides/HDL cholesterol (P=0.016) while increasing HDL cholesterol (P<0.001) and apolipoprotein AI (P=0.001). Of note, when compared with omega-3 fatty acids, fenofibrate therapy decreased fasting insulin (P=0.023) and increased plasma adiponectin (P=0.002) and insulin sensitivity (P=0.015).
  
  
  CONCLUSIONS
  Omega-3 fatty acids and fenofibrate therapy promoted similar changes in triglycerides and endothelium-dependent dilation. However, fenofibrate therapy had substantially better effects on lipoprotein and metabolic profiles in patients with hypertriglyceridemia.
authors.affiliation: Cardiology, Gachon University Gil Hospital, Incheon, Republic of Korea. kwangk@gilhospital.com
authors.forename: Kwang Kon
authors.initials: KK
authors.lastname: Koh
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Quon
authors.forename: Kwen-Chul
authors.initials: KC
authors.lastname: Shin
authors.forename: Soo
authors.initials: S
authors.lastname: Lim
authors.forename: Yonghee
authors.initials: Y
authors.lastname: Lee
authors.forename: Ichiro
authors.initials: I
authors.lastname: Sakuma
authors.forename: Kyounghoon
authors.initials: K
authors.lastname: Lee
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Han
authors.forename: Eak Kyun
authors.initials: EK
authors.lastname: Shin
mesh_terms: D052242:Adiponectin / Q000097:blood; D000704:Analysis of Variance; D016632:Apolipoprotein A-I / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D008076:Cholesterol, HDL / Q000097:blood; D019587:Dietary Supplements; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005260:Female; D011345:Fenofibrate / Q000627:therapeutic use*; D005340:Fibrinogen / Q000378:metabolism; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D018836:Inflammation Mediators / Q000097:blood; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D014664:Vasodilation / Q000187:drug effects
chemical_list: D052242:Adiponectin; D016632:Apolipoprotein A-I; D015415:Biomarkers; D001786:Blood Glucose; D002097:C-Reactive Protein; D008076:Cholesterol, HDL; D015525:Fatty Acids, Omega-3; D011345:Fenofibrate; D005340:Fibrinogen; D006442:Glycated Hemoglobin; D000960:Hypolipidemic Agents; D018836:Inflammation Mediators; D007328:Insulin; D014280:Triglycerides; C499918:ADIPOQ protein, human; C505693:APOA1 protein, human; C517652:hemoglobin A1c protein, human