title: Omega-3 polyunsaturated fatty acids in the treatment of hypertriglyceridaemia.
abstract: Hypertriglyceridaemia (HTG) is an independent risk factor for cardiovascular disease; high-risk patients with HTG, such as those with metabolic syndrome or diabetes, may benefit from hypolipidaemic therapies. Several lipid-lowering drugs act by reducing triglyceride (TG) levels, including fibrates, nicotinic acid and omega-3 fatty acids. The omega-3 polyunsaturated fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) dose-dependently reduce plasma TG levels; the effect tends to be greater in patients with higher TG levels at baseline. Evidence from clinical trials suggests that EPA+DHA doses of ≥ 2 g/day are required to achieve significant effects. The optimal TG-lowering doses of EPA+DHA are 3-4 g/day, with little evidence to support lipid-altering efficacy of doses of EPA and DHA <1g/day. Predicted changes in fasting serum TG levels at the recommended dietary intakes of EPA and/or DHA of 200-500 mg/day are -3.1% to -7.2%. Reductions of plasma TG levels at the optimal doses are from 25-35% up to 45% in the presence of severely elevated TG levels (≥ 500 mg/dl; ≥ 5.65 mmol/l), along with a reduction in non-high-density lipoprotein-cholesterol (non-HDL-C) and an increase in HDL-C. This observation has also been confirmed in statin-treated patients.
authors.affiliation: Center for the Study of Atherosclerosis, Bassini Hospital, Cinisello Balsamo, Italy; IRCCS MultiMedica, Milan, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Pirillo
authors.affiliation: IRCCS MultiMedica, Milan, Italy; Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy. Electronic address: alberico.catapano@unimi.it.
authors.forename: Alberico Luigi
authors.initials: AL
authors.lastname: Catapano
mesh_terms: D000818:Animals; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage* / Q000378:metabolism; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood* / Q000178:diet therapy*; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
chemical_list: D015525:Fatty Acids, Omega-3; D014280:Triglycerides
keywords: Diabetes; Docosahexaenoic acid; Eicosapentaenoic acid; Hypertriglyceridaemia; Omega-3 fatty acids; Triglyceride