n-3 PUFA esterified to glycerol or as ethyl esters reduce non-fasting plasma triacylglycerol in subjects with hypertriglyceridemia: a randomized trial.
To date, treatment of hypertriglyceridemia with long-chain n-3 polyunsaturated fatty acids (n-3 PUFA) has been investigated solely in fasting and postprandial subjects. However, non-fasting triacylglycerols are more strongly associated with risk of cardiovascular disease. The objective of this study was to investigate the effect of long-chain n-3 PUFA on non-fasting triacylglycerol levels and to compare the effects of n-3 PUFA formulated as acylglycerol (AG-PUFA) or ethyl esters (EE-PUFA). The study was a double-blinded randomized placebo-controlled interventional trial, and included 120 subjects with non-fasting plasma triacylglycerol levels of 1.7-5.65 mmol/L (150-500 mg/dL). The participants received approximately 3 g/day of AG-PUFA, EE-PUFA, or placebo for a period of eight weeks. The levels of non-fasting plasma triacylglycerols decreased 28% in the AG-PUFA group and 22% in the EE-PUFA group (P < 0.001 vs. placebo), with no significant difference between the two groups. The triacylglycerol lowering effect was evident after four weeks, and was inversely correlated with the omega-3 index (EPA + DHA content in erythrocyte membranes). The omega-3 index increased 63.2% in the AG-PUFA group and 58.5% in the EE-PUFA group (P < 0.001). Overall, the heart rate in the AG-PUFA group decreased by three beats per minute (P = 0.045). High-density lipoprotein (HDL) cholesterol increased in the AG-PUFA group (P < 0.001). Neither total nor non-HDL cholesterol changed in any group. Lipoprotein-associated phospholipase A2 (LpPLA2) decreased in the EE-PUFA group (P = 0.001). No serious adverse events were observed. Supplementation with long-chain n-3 PUFA lowered non-fasting triacylglycerol levels, suggestive of a reduction in cardiovascular risk. Regardless of the different effects on heart rate, HDL, and LpPLA2 that were observed, compared to placebo, AG-PUFA, and EE-PUFA are equally effective in reducing non-fasting triacylglycerol levels.
Department of Clinical Biochemistry, Copenhagen University Hospital Gentofte, Niels Andersensvej 65, 2900, Hellerup, Denmark, anne.hedengran.nedergaard.02@regionh.dk.
Anne
A
Hedengran
Pal B
PB
Szecsi
Jørn
J
Dyerberg
William S
WS
Harris
Steen
S
Stender
D000368:Aged; D004311:Double-Blind Method; D004952:Esters / Q000737:chemistry / Q000627:therapeutic use; D005215:Fasting / Q000097:blood; D015525:Fatty Acids, Omega-3 / Q000737:chemistry / Q000627:therapeutic use*; D005260:Female; D005989:Glycerides / Q000737:chemistry / Q000627:therapeutic use; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood* / Q000178:diet therapy*; D008297:Male; D008875:Middle Aged; D014280:Triglycerides / Q000097:blood*
D004952:Esters; D015525:Fatty Acids, Omega-3; D005989:Glycerides; D014280:Triglycerides