Effects of Eicosapentaenoic Acid Versus Docosahexaenoic Acid on Serum Lipids: A Systematic Review and Meta-Analysis

Abstract

Omega-3 fatty acid supplements containing both eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been shown to reduce triglycerides but also increase low-density lipoprotein (LDL). Whether EPA or DHA given as monotherapy has differential effects on serum lipoproteins has not been systematically evaluated. We performed a meta-analysis of randomized placebo-controlled trials of monotherapy with EPA (n=10), DHA (n=17), or EPA versus DHA (n=6). Compared with placebo, DHA raised LDL 7.23 mg/dL (95% CI, 3.98–10.5) whereas EPA non-significantly reduced LDL. In direct comparison studies, DHA raised LDL 4.63 mg/dL (95% CI, 2.15–7.10) more than EPA. Both EPA and DHA reduced triglycerides, with a greater reduction by DHA in direct comparison studies. DHA also raised high-density lipoprotein (4.49 mg/dL; 95% CI, 3.50–5.48) compared with placebo, whereas EPA did not. Although EPA and DHA both reduce triglycerides, they have divergent effects on LDL and high-density lipoprotein. Further research is needed to elucidate the mechanisms and significance of these differences.

Eicosapentaenoic Acid, Arachidonic Acid and Eicosanoid Metabolism in Juvenile Barramundi Lates calcarifer

“…Although it is an unlikely real-world scenario to include high levels of any one LC-PUFA, these observations and those of a previous study, confirm that there are no growth stimulatory effects owing to any individual LC-PUFA in juvenile barramundi (Glencross and Rutherford, 2011). In many species, EPA can exert cardio-protective benefits such as lowering triglycerides and low-density lipoprotein levels (Aarsland et al, 1990;Cahill et al, 1988;Cottin et al, 2011;Wei and Jacobson, 2011;Weiner et al, 1986). Whereas ARA on the other hand, is an essential and necessary precursor to the 2-series and 4-series eicosanoids that mediate homeostasis during times of environmental or physiological stress (Bell and Sargent, 2003).…”

The Change in Low-Density Lipoprotein Cholesterol Concentration is Positively Related to Plasma Docosahexaenoic Acid but not Eicosapentaenoic Acid

“…We speculated that the change in DHA concentration strongly influenced the relationship between the change in LDL cholesterol and EPA in the control group, because both EPA and DHA are n-3 PUFA present in food. A recent interventional trial suggested the retroconversion from DHA to EPA in LDL particles 19) , but we speculated that DHA intake will increase serum LDL-cholesterol because fish oil (EPA＋DHA) intervention increased LDLcholesterol significantly 20) and pure EPA intervention LDL cholesterol and the change in EPA (adjusted for DHA) was −0.007 (p = 0.416), and in DHA (adjusted for EPA) was 0.131 (p＜0.001). Similarly, the partial correlation coefficient between the changes in L/H ratio and the change in EPA was 0.0004 (p = 0.965), and in DHA was 0.099 (p＜0.001).…”

ESC/EAS Guidelines for the management of dyslipidaemias

“…281 -283 The efficacy of omega-3 fatty acids to lower serum TGs has also been reported in meta-analyses. 284 One meta-analysis included 63 030 subjects from 20 trials and reported no overall effect of omega-3 fatty acids on composite CV events {relative risk to study the potential benefits of EPA on CVD outcomes in subjects with elevated serum TGs are ongoing. REDUCE-IT aims to recruit 8000 subjects and STRENGTH 13 000 subjects.…”