Abstract-Hypertriglyceridemia may contribute to the development of atherosclerosis by increasing expression of cell adhesion molecules (CAMs). Although the cellular expression of CAMs is difficult to assess clinically, soluble forms of CAMs (sCAMs) are present in the circulation and may serve as markers for CAMs. In this study, we examined the association between sCAMs and other risk factors occurring with hypertriglyceridemia, the effect of triglyceride reduction on sCAM levels, and the role of soluble vascular cell adhesion molecule-1 (sVCAM-1) in monocyte adhesion in vitro. Compared with normal control subjects (nϭ20), patients with hypertriglyceridemia and low HDL (nϭ39) had significantly increased levels of soluble intercellular adhesion molecule-1 (sICAM-1) (316Ϯ28.8 versus 225Ϯ16.6 ng/mL), sVCAM-1 (743Ϯ52.2 versus 522Ϯ43.6 ng/mL), and soluble E-selectin (83Ϯ5.9 versus 49Ϯ3.6 ng/mL). ANCOVA showed that the higher sCAM levels in patients occurred independently of diabetes mellitus and other risk factors. In 27 patients who received purified n-3 fatty acid (Omacor) 4 g/d for Ն7 months, triglyceride level was reduced by 47Ϯ4.6%, sICAM-1 level was reduced by 9Ϯ3.4% (Pϭ.02), and soluble E-selectin level was reduced by 16Ϯ3.2% (PϽ.0001), with the greatest reduction in diabetic patients. These results support previous in vitro data showing that disorders in triglyceride and HDL metabolism influence CAM expression and treatment with fish oils may alter vascular cell activation. In a parallel-plate flow chamber, recombinant sVCAM-1 at the concentration seen in patients significantly inhibited adhesion of monocytes to interleukin-

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