Long-term effects of fish oil on lipoprotein subfractions and low density lipoprotein size in non-insulin-dependent diabetic patients with hypertriglyceridemia

Patti, L.; Maffettone, Ada; Iovine, C; Marino, L.; Annuzzi, Giovanni; Riccardi, Gabriele; Rivellese, Angela Albarosa

doi:10.1016/s0021-9150(99)00149-5

Cited by 29 publications

(19 citation statements)

References 37 publications

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“…The trials included in the pooled analyses were small, with a median of 23 patients. Seventeen of the published papers were duplicate publications of six trials [22, 27, 33, 34, 36-38, 40, 42-46, 48, 51, 54, 55]; multiple papers for each trial are indicated by the following grouping of references: [22,38], [27,34,36,37], [40,54,55], [42,48,51], [43,46], [44,45]. There was sufficient information on only 12 of the 98 outcomes to allow data to be pooled, the results of which are shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Apolipoprotein AII was also measured by one trial with 14 patients [52], showing a significant reduction with n-3 PUFA. Lipoprotein lipase was assessed by three trials [32,42,53], all showing no change after n-PUFA or compared with control. Two trials [32,53] measuring lipoprotein(a) could not be pooled due to insufficient data, but both reported no difference between intervention and control groups.…”

Section: Very Low Density Lipoprotein Cholesterol and Subfractionsmentioning

confidence: 99%

“…F2 isoprostanes were reduced with n-3 PUFA in a trial of 51 subjects [40], as were lipid peroxides in another of 40 subjects [31] (Table 2). One study measured 27 different lipid particle sizes in 16 subjects [42], showing that n-3 PUFA increased small LDL cholesterol percentage composition. Another two trials showed no difference in LDL particle size with n-3 PUFA [46,48].…”

Section: Very Low Density Lipoprotein Cholesterol and Subfractionsmentioning

confidence: 99%

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Meta-analysis of the effects of n-3 polyunsaturated fatty acids on lipoproteins and other emerging lipid cardiovascular risk markers in patients with type 2 diabetes

et al. 2007

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Aims/hypothesis To determine the effects of marine-derived n-3 polyunsaturated fatty acids (PUFA) on established and emerging lipid and lipoprotein cardiovascular risk markers in patients with type 2 diabetes. Materials and methods We performed a systematic review and meta-analysis of randomised controlled trials comparing dietary or non-dietary intake of n-3 PUFA with placebo in patients with type 2 diabetes by searching databases from 1966 to December 2006. Changes in the following variables were recorded triacylglycerol; total cholesterol; HDL, LDL and VLDL and their subfractions; lipid ratios; apolipoproteins; and cholesterol particle sizes. Results There were 23 trials on non-dietary supplementation, involving 1,075 subjects with a mean treatment duration of 8.9 weeks, with sufficient data to permit pooling. Compared with placebo, n-3 PUFA had a statistically significant effect on four outcomes, reducing levels of (1) triacylglycerol (18 trials, 969 subjects) by 25% (mean 0.45 mmol/l; 95% CI −0.58 to −0.32; p<0.00001); (2) VLDL-cholesterol (7 trials, 238 subjects) by 36% (0.07 mmol/l; 95% CI −0.13 to 0.00; p=0.04); and (3) VLDL-triacylglycerol (6 trials, 178 subjects) by 39.7% (0.44 mmol/l; 95% CI −0.83 to −0.05; p= 0.03); while slightly increasing LDL (16 trials, 565 subjects) by 5.7% (0.11 mmol/l; 95% CI 0.00 to 0.22; p=0.05). There were no significant effects on total cholesterol, apolipoproteins, lipid subfractions or ratios. Conclusions/interpretation In addition to recognised triacylglycerol-lowering effects, n-3 PUFA supplementation decreases VLDL-cholesterol and VLDL-triacylglycerol, but may have an adverse effect on LDL-cholesterol. Larger and longer term clinical trials are required to conclusively establish the effect of n-3 PUFA on cardiovascular risk markers and outcomes in type 2 diabetic patients.

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Section: Resultsmentioning

confidence: 99%

Section: Very Low Density Lipoprotein Cholesterol and Subfractionsmentioning

confidence: 99%

Section: Very Low Density Lipoprotein Cholesterol and Subfractionsmentioning

confidence: 99%

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Meta-analysis of the effects of n-3 polyunsaturated fatty acids on lipoproteins and other emerging lipid cardiovascular risk markers in patients with type 2 diabetes

et al. 2007

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“…The reductions of VLDL size and reduced concentration of large VLDL that we observed have, to our knowledge, not been previously reported. Others have reported no change in the distribution of VLDL subclasses in subjects with type II diabetes (Patti et al, 1999) or did not measure these subclasses (Petersen et al, 2002). Reduction of VLDLcholesterol, on the other hand, is well documented but mainly in the setting of a concomitant lowering of triglycerides (Harris et al, 1983;Malasanos and Stacpoole, 1991;Connor, 2000;Montori et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

“…It is therefore important to investigate effects of n-3 FA on subclasses and size of lipoproteins in subjects with type II diabetes (Syvänne and Taskinen, 1997;Julius, 2003;Steinmetz, 2003). However, such investigations in diabetes by standard methods (ultracentrifugation, gradient gel electrophoresis) have so far given sparse and diverging results (Luo et al, 1998;Patti et al, 1999;Petersen et al, 2002). Measurements using nuclear magnetic resonance (NMR) relate to the severity of cardiovascular disease (Freedman et al, 1998) and could provide needed details of lipoprotein size and subclasses (Otvos, 2002).…”

Section: Introductionmentioning

confidence: 99%

Effects of marine n-3 fatty acid supplementation on lipoprotein subclasses measured by nuclear magnetic resonance in subjects with type II diabetes

et al. 2007

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Objective: To measure effects of fish oil supplements on lipoprotein subclasses by nuclear magnetic resonance (NMR) in subjects with type II diabetes and relate them to insulin sensitivity. Design: Two-armed, parallel, placebo-controlled, randomized. Subjects: Normotriglyceridemic subjects with type II diabetes without insulin treatment were given either fish oil (n ¼ 12, median intake 5.9 g/day total n-3 fatty acids (FA) (1.8 g 20:5n-3, 3.0 g 22:6n-3)) or corn oil (n ¼ 14, 8.5 g/day 18:2n-6 FA). Methods: Size and concentration of lipoproteins subclasses were measured by NMR, insulin sensitivity by hyperinsulinemic, isoglycemic clamps. Results: After 9 weeks, there were differences between those treated with fish and corn oil with respect to very low-density lipoprotein (VLDL) size (median À15 vs þ 0.6%, P ¼ 0.001), particle concentrations of large VLDL (À99 vs À4.1%, P ¼ 0.041) and small high-density lipoprotein (HDL) (À12 vs þ 10%, P ¼ 0.051). Compared with corn oil fish oil tended to increase HDL size and small low-density lipoprotein ( LDL) concentration (P ¼ 0.063 and 0.068, respectively, for differences between groups). There was no effect on oxidized LDL. Insulin sensitivity (glucose utilization) decreased in the fish oil group compared with the corn oil group (P ¼ 0.049). The decrease in insulin sensitivity did not correlate with the effects on lipoprotein subclasses. Conclusions: A high intake of n-3 FA exerts effects on several lipoprotein subclasses without obvious influence from changes in insulin sensitivity.

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Omega 3 fatty acids for prevention and treatment of cardiovascular disease

Hooper

2004

Cochrane Database of Systematic Reviews

191

143

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Background It has been suggested that omega 3 (W3, n-3 or omega-3) fats from oily fish and plants are beneficial to health. Objectives To assess whether dietary or supplemental omega 3 fatty acids alter total mortality, cardiovascular events or cancers using both RCT and cohort studies. Search methods Five databases including CENTRAL, MEDLINE and EMBASE were searched to February 2002. No language restrictions were applied. Bibliographies were checked and authors contacted. Selection criteria RCTs were included where omega 3 intake or advice was randomly allocated and unconfounded, and study duration was at least six months. Cohorts were included where a cohort was followed up for at least six months and omega 3 intake estimated. Data collection and analysis Studies were assessed for inclusion, data extracted and quality assessed independently in duplicate. Random effects meta-analysis was performed separately for RCT and cohort data. Main results Forty eight randomised controlled trials (36,913 participants) and 41 cohort analyses were included. Pooled trial results did not show a reduction in the risk of total mortality or combined cardiovascular events in those taking additional omega 3 fats (with significant statistical heterogeneity). Sensitivity analysis, retaining only studies at low risk of bias, reduced heterogeneity and again suggested no significant effect of omega 3 fats. Restricting analysis to trials increasing fish-based omega 3 fats, or those increasing short chain omega 3s, did not suggest significant effects on mortality or cardiovascular events in either group. Subgroup analysis by dietary advice or supplementation, baseline risk of CVD or omega 3 dose suggested no clear effects of these factors on primary outcomes. Neither RCTs nor cohorts suggested increased relative risk of cancers with higher omega 3 intake but estimates were imprecise so a clinically important effect could not be excluded. Authors’ conclusions It is not clear that dietary or supplemental omega 3 fats alter total mortality, combined cardiovascular events or cancers in people with, or at high risk of, cardiovascular disease or in the general population. There is no evidence we should advise people to stop taking rich sources of omega 3 fats, but further high quality trials are needed to confirm suggestions of a protective effect of omega 3 fats on cardiovascular health. There is no clear evidence that omega 3 fats differ in effectiveness according to fish or plant sources, dietary or supplemental sources, dose or presence of placebo.

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Long-term effects of fish oil on lipoprotein subfractions and low density lipoprotein size in non-insulin-dependent diabetic patients with hypertriglyceridemia

Cited by 29 publications

References 37 publications

Meta-analysis of the effects of n-3 polyunsaturated fatty acids on lipoproteins and other emerging lipid cardiovascular risk markers in patients with type 2 diabetes

Meta-analysis of the effects of n-3 polyunsaturated fatty acids on lipoproteins and other emerging lipid cardiovascular risk markers in patients with type 2 diabetes

Effects of marine n-3 fatty acid supplementation on lipoprotein subclasses measured by nuclear magnetic resonance in subjects with type II diabetes

Omega 3 fatty acids for prevention and treatment of cardiovascular disease

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