Effects of fish oil rich in eicosapentaenoic acid on serum lipid in hyperlipidemic hemodialysis patients

Abstract

The incidence of atherosclerosis in hemodialysis (HD) patients is very high. Major risk factors are aging, lipid metabolism disturbances, high blood pressure, and smoking. High blood pressure and hypertriglyceridemia, which is atherogenic in the presence of smoking, are encountered very often in HD patients. The effects of eicosapentaenoic acid (EPA) on plasma lipids and blood pressure were studied for the first time in HD patients by the administration of capsules containing fish oil rich in EPA, which is known to lower serum lipid concentration and blood pressure. We treated 12 hyperlipidemic patients (3 of type IIa, 3 of type IIb, and 6 of type IV; 3 males, 9 females; 31 to 70 years of age; 4 to 90 months on HD) with 24 capsules (1.6 g EPA and 1.0 g docosahexaenoic acid) per day for 13 weeks. Serum triglycerides, total cholesterol, and phospholipid decreased significantly after capsule administration. The ratio of EPA to arachidonic acid in serum increased significantly. There was a small but statistically significant decrease in platelet count. Diastolic blood pressure decreased at the end of the experiment. These effects of fish oil are considered favorable for the prevention of atherosclerosis and its subsequent diseases.

Omega 3 (n−3) fatty acids down-regulate nuclear factor-kappa B (NF-κB) gene and blood cell adhesion molecule expression in patients with homozygous sickle cell disease

“…The observed decrease in TWBC owing to n −3 fatty acids supplementation is constituent with findings obtained from conditions other than SCD [29][30][31] and patients with SCD [16]. It is tenable; this 524.3 ± 141.4 487.6 ± 141.4 509.6 ± 232.9 484.5 ± 217.5 reduction in blood cell count was a manifestation of an improved inflammatory state [32,33] or diminished haemopoietic activity of the bone marrow [34].…”

Effects of Omega-3 Fatty Acids on Serum Lipids, Lipoprotein (a), and Hematologic Factors in Hemodialysis Patients

“…In agreement with these findings, the majority of previous studies have shown that omega-3 fatty acids caused no changes in serum total cholesterol 15,21,27,30,31,33 and LDL-C. 15,27,33 In contrast, some studies have indicated that omega-3 fatty acids reduce serum concentrations of total cholesterol 26,29 and LDL-C. 25,32 These contradictory findings may be because of the duration and dosage of omega-3 fatty acids supplementation, as well as differences in baseline serum levels of total cholesterol and LDL-C. As is usual in hemodialysis patients, serum total cholesterol and LDL-C were normal in our study participants; therefore, omega-3 fatty acids supplement was not expected to have any effect on serum total cholesterol and LDL-C.…”

“…This finding was in agreement with those of the majority of previous studies. 15,16,[24][25][26][27][28][29][30][31][32][33] Omega-3 fatty acids inhibit hepatic synthesis of fatty acids and consequently triglycerides by suppressing gene expression of sterol regulatory element-binding proteins and enhancement of their proteasome degradation, which result in reduced gene expression of enzymes involved in fatty acids synthesis, that is, acetylcoenzyme A carboxylase and fatty acid synthetase complex. [34][35][36] Reduced synthesis of fatty acids and triglyceride in liver causes a decrease in VLDL formation and consequently reduces serum triglyceride concentration.…”

Review of the Effects of Omega-3 Supplementation in Dialysis Patients

“…Of the 12 studies performed in dialysis patients that measured this end point (54 -59,61,70,71,73,75,78), only four used a randomized, controlled design (70,71,73,75). Three of the 12 studies reported that fish oil therapy significantly reduced diastolic (7 to 15 mmHg) and/or systolic BP (16 to 30 mmHg) (54,59,73). The only controlled study with positive findings noted a dramatic reduction in systolic and diastolic pressures, although this study was not designed with BP as a primary outcome (73).…”

“…Overall, there are no clear effects of fish oil-derived omega-3 fatty acids on platelet aggregation, blood viscosity, red blood cell survival, and bleeding times, even at high doses (1.7 to 7.6 g/d) (52)(53)(54)(55)(56)58,69,70,(75)(76)(77). Four of eight studies found a reduction in platelet counts (54,56,57,66), although only one dropped below the normative range (54). No effect on the prothrombin or partial thromboplastin times was documented (53,70,76).…”