title: A double-blind randomized trial of fish oil to lower triglycerides and improve cardiometabolic risk in adolescents.
abstract: OBJECTIVE
  To determine the efficacy of 4 g/day fish oil to lower triglycerides and impact lipoprotein particles, inflammation, insulin resistance, coagulation, and thrombosis.
  
  
  METHODS
  Participants (n = 42, age 14 ± 2 years) with hypertriglyceridemia and low-density lipoprotein (LDL) cholesterol <160 mg/dL were enrolled in a randomized, double-blind, crossover trial comparing 4 g of fish oil daily with placebo. Treatment interval was 8 weeks with a 4-week washout. Lipid profile, lipoprotein particle distribution and size, glucose, insulin, high-sensitivity C-reactive protein, interleukin-6, fibrinogen, plasminogen activator inhibitor-1, and thrombin generation were measured.
  
  
  RESULTS
  Baseline lipid profile was total cholesterol 194 (5.4) mg/dL (mean [SE]), triglycerides 272 (21) mg/dL, high-density lipoprotein cholesterol 39 (1) mg/dL, and LDL cholesterol 112 (3.7) mg/dl. LDL particle number was 1614 (60) nmol/L, LDL size was 19.9 (1.4) nm, and large very low-density lipoprotein/chylomicron particle number was 9.6 (1.4) nmol/L. Triglycerides decreased on fish oil treatment but the difference was not significant compared with placebo (-52 ± 16 mg/dL vs -16 ± 16 mg/dL). Large very low-density lipoprotein particle number was reduced (-5.83 ± 1.29 nmol/L vs -0.96 ± 1.31 nmol/L; P < .0001). There was no change in LDL particle number or size. There was a trend towards a lower prothrombotic state (lower fibrinogen and plasminogen activator inhibitor-1; .10 > P > .05); no other group differences were seen.
  
  
  CONCLUSIONS
  In children, fish oil (4 g/day) lowers triglycerides slightly and may have an antithrombotic effect but has no effect on LDL particles.
authors.affiliation: Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE; Division of Nephrology, Department of Internal Medicine, Thomas Jefferson University, Philadelphia, PA. Electronic address: samuel.gidding@nemours.org.
authors.forename: Samuel S
authors.initials: SS
authors.lastname: Gidding
authors.affiliation: Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE.
authors.forename: Carol
authors.initials: C
authors.lastname: Prospero
authors.affiliation: Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE.
authors.forename: Jobayer
authors.initials: J
authors.lastname: Hossain
authors.affiliation: Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE; Division of Nephrology, Department of Internal Medicine, Thomas Jefferson University, Philadelphia, PA.
authors.forename: Frances
authors.initials: F
authors.lastname: Zappalla
authors.affiliation: Department of Research, The Nemours Children's Clinic, Wilmington, DE; Mayo Clinic College of Medicine, Rochester, MN.
authors.forename: Prabhakaran Babu
authors.initials: PB
authors.lastname: Balagopal
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Thomas Jefferson University, Philadelphia, PA.
authors.forename: Bonita
authors.initials: B
authors.lastname: Falkner
authors.affiliation: Department of Pediatrics, Johns Hopkins University, Baltimore, MD.
authors.forename: Peter
authors.initials: P
authors.lastname: Kwiterovich
mesh_terms: D000293:Adolescent; D001777:Blood Coagulation / Q000187:drug effects; D008078:Cholesterol, LDL / Q000097:blood* / Q000187:drug effects*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage*; D006331:Heart Diseases / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood* / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D007249:Inflammation / Q000209:etiology / Q000517:prevention & control; D007333:Insulin Resistance; D008297:Male; D008659:Metabolic Diseases / Q000209:etiology / Q000517:prevention & control; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control; D014280:Triglycerides
chemical_list: D008078:Cholesterol, LDL; D005395:Fish Oils; D014280:Triglycerides