Effects of aspirin in combination with EPA and DHA on HDL-C cholesterol and ApoA1 exchange in individuals with type 2 diabetes mellitus

Abstract

Background/Synopsis Low-dose aspirin is an effective drug for the prevention of cardiovascular disease (CVD) events but individuals with diabetes mellitus can be subject to ‘aspirin resistance’. Thus, aspirin’s effect in these individuals is controversial. Higher blood levels of seafood-derived omega-3 polyunsaturated fatty acids (ω3) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) also have beneficial effects in reducing risk of CVD events but few studies have examined the interaction of plasma EPA and DHA with aspirin ingestion. Objective/Purpose Our study examined the combinatory effects of EPA, DHA, and aspirin ingestion on HDL-cholesterol (HDL-C) and apoA-I exchange (shown to be associated with CVD event risk). Methods 30 adults with Type 2 diabetes mellitus ingested aspirin (81 mg/day) for 7 consecutive days, EPA+DHA (2.6g/day) for 28 days, then both for 7 days. Plasma was collected at baseline and at 5 subsequent visits including 4 hours after each aspirin ingestion. Mixed model methods were used to determine HDL-C-concentrations and apoA-I exchange compared to the baseline visit values. LOWESS curves were used for non-linear analyses of outcomes to help discern change patterns, which was followed by piecewise linear functions for formal testing of curvilinear relationships. Results Significant changes (p<0.05) compared to baseline in both HDL-C-concentrations and apoA-I exchange were present at different times. After 7 days of aspirin-only ingestion, apoA-I exchange was significantly modified by increasing levels of DHA concentration, with increased apoA-I exchange observed up until log(DHA) of 4.6 and decreased exchange thereafter (p=0.03). These LOWESS curve effects were not observed for EPA or HDL-C (p>0.05). Aspirin’s effects on apoA-I exchange were the greatest when EPA or DHA concentrations were moderate compared to high or low. Comparison of EPA, DHA, and EPA+DHA LOWESS curves, demonstrated that the majority of the effect is due to DHA. Conclusion Our results strongly suggest that plasma concentrations of EPA and DHA influence aspirin effects on lipid mediators of CVD event risk where their concentrations are most beneficial when moderate, not high or low. These effects on HDL-C cholesterol and apoA-I exchange are novel. Personalized dosing of DHA in those who take aspirin may be a beneficial option for patients with type 2 diabetes mellitus.

Recommendation of Aspirin-Guide App and Physicians Clinical Decision of Aspirin Use to Prevent CVD Among Diabetic Patients, Is there any Differences?

“…Mortality from CVD in patients with type 2 diabetes is currently high, and while some studies did not find benefits in the use of aspirin in patients with type 2 diabetes, others have reported that statin therapy alone is considered the effective and preferred intervention to prevent CVD in type 2 diabetes. [18][19][20] This is in line with our study finding of statin use being a significant determinant of aspirin use in T2DM patients. Statins are known to reduce the risk of CVD events and mortality from CVD in patients including those with T2DM.…”

Protein expression profiling of rat uteruses with primary dysmenorrhea syndrome

“…Cholesterol has been to be enriched in microdomains of the plasma membrane known as rafts and caveolae, which have been implicated in cellular signaling cascades [17]. Apolipoprotein A1 (Apoa1), which is the major protein component of high density lipoprotein (HDL) in plasma, plays an important role in cholesterol transport [18][19][20][21]. In the present study, the expression level of Apoa1 was signi cantly increased in the uterus of PD rats.…”

Aspirin and omega-3 polyunsaturated fatty acid use and their interaction in cardiovascular diseases and colorectal adenomas

“…The role of EPA or DHA with ASA showed that the effects of ASA on HDL-C and HDL ApoA1 exchange depended on DHA concentrations and not on EPA (73) . Because ApoA1 exchange is critical in generating HDL responsible for cardioprotection, beneficial effects from ASA on CVD have, thus, been shown as dependent on having moderate plasma DHA concentration.…”