Hypertriglyceridemia omega-3 fatty acids: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
(/* Advantages {{cite journal| author=Nestel PJ, Connor WE, Reardon MF, Connor S, Wong S, Boston R| title=Suppression by diets rich in fish oil of very low density lipoprotein production in man. | journal=J Clin Invest | year= 1984 | volume= 74 | issu)
No edit summary
Line 7: Line 7:
==Overview==
==Overview==
Treatment of hypertriglyceridemia is by restriction of carbohydrates and fat in the [[diet (nutrition)|diet]], as well as with [[niacin]], [[fibrate]]s and [[statin]]s (three classes of drugs).  Increased [[fish oil]] intake may substantially lower an individual's triglycerides.<ref>{{cite web |url=http://www.lipidsonline.org/slides/slide01.cfm?q=hypertriglyceridemia&dpg=13 |title=Lipids Online Slides: hypertriglyceridemia, ICAM-1, fish oil, E-selectin | format= |work=}}</ref><ref name="pmid2035283">{{cite journal |author=Terres W, Beil U, Reimann B, Tiede S, Bleifeld W |title=[Low-dose fish oil in primary hypertriglyceridemia. A randomized placebo-controlled study] |language=German |journal=Zeitschrift für Kardiologie |volume=80 |issue=1 |pages=20-4 |year=1991 |pmid=2035283 |doi=}}</ref><ref>{{cite web |url=http://www.findarticles.com/p/articles/mi_m0887/is_n4_v9/ai_8960077 |title=Fish oils in hypertriglyceridemia - Fish Oils Revisited Nutrition Research Newsletter - Find Articles |format= |work=}}</ref>.  
Treatment of hypertriglyceridemia is by restriction of carbohydrates and fat in the [[diet (nutrition)|diet]], as well as with [[niacin]], [[fibrate]]s and [[statin]]s (three classes of drugs).  Increased [[fish oil]] intake may substantially lower an individual's triglycerides.<ref>{{cite web |url=http://www.lipidsonline.org/slides/slide01.cfm?q=hypertriglyceridemia&dpg=13 |title=Lipids Online Slides: hypertriglyceridemia, ICAM-1, fish oil, E-selectin | format= |work=}}</ref><ref name="pmid2035283">{{cite journal |author=Terres W, Beil U, Reimann B, Tiede S, Bleifeld W |title=[Low-dose fish oil in primary hypertriglyceridemia. A randomized placebo-controlled study] |language=German |journal=Zeitschrift für Kardiologie |volume=80 |issue=1 |pages=20-4 |year=1991 |pmid=2035283 |doi=}}</ref><ref>{{cite web |url=http://www.findarticles.com/p/articles/mi_m0887/is_n4_v9/ai_8960077 |title=Fish oils in hypertriglyceridemia - Fish Oils Revisited Nutrition Research Newsletter - Find Articles |format= |work=}}</ref>.  
==Omega-3 fatty acids==
===Mechanism of benefit===
* Decreased hepatic [[lipogenesis]]
* Increased plasma [[lipoprotein lipase]] activity.
* Increased hepatic mitochondrial and peroxisomal [[beta-oxidation]]
* Inhibition of acyl CoA:1,2-[[diacylglycerol acyltransferase]] enzyme
* [[Omega-3 fatty acid]]'s component [[eicosapentaenoic acid]] (EPA), and [[docosahexaenoic acid]] (DHA) are poor enzyme substrates for [[triglyceride]] synthesis in the [[liver]].
* EPA and DHA inhibits esterification of other fatty acids.
===Advantages <ref name="pmid6736254">{{cite journal| author=Nestel PJ, Connor WE, Reardon MF, Connor S, Wong S, Boston R| title=Suppression by diets rich in fish oil of very low density lipoprotein production in man. | journal=J Clin Invest | year= 1984 | volume= 74 | issue= 1 | pages= 82-9 | pmid=6736254 | doi=10.1172/JCI111422 | pmc=PMC425187 | url= }} </ref>, <ref name="pmid11303007">{{cite journal| author=Durrington PN, Bhatnagar D, Mackness MI, Morgan J, Julier K, Khan MA et al.| title=An omega-3 polyunsaturated fatty acid concentrate administered for one year decreased triglycerides in simvastatin treated patients with coronary heart disease and persisting hypertriglyceridaemia. | journal=Heart | year= 2001 | volume= 85 | issue= 5 | pages= 544-8 | pmid=11303007 | doi= | pmc=PMC1729738 | url= }} </ref>===
Advantages seen with ≥3 grams/day [[eicosapentaenoic acid]] and [[docosahexaenoic acid]] (EPA/DHA) concentrate are
* Decreased [[very low-density lipoprotein]] [[VLDL]] production
* Decreased serum triglyceride concentration by ≥ 50%
However, larger randomized trials are required to prove the benefit and safety of these drugs in wider cross-section of population.
===Side-effects===
* Dose dependent gastrointestinal side-effects like [[nausea]] (approximately 4 % of individuals at < 3 gm/d, and 20% at > 4gm/d experiences gastrointestinal side-effects)<ref name="pmid16825676">{{cite journal| author=Wang C, Harris WS, Chung M, Lichtenstein AH, Balk EM, Kupelnick B et al.| title=n-3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review. | journal=Am J Clin Nutr | year= 2006 | volume= 84 | issue= 1 | pages= 5-17 | pmid=16825676 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16825676  }} </ref>
* The peculiar fishy smell can be a reason for discontinuation among many patients. This can be reduced by
** Freezing of medication
** Trying different medication preparation
** Taking medication with food
* Increased incidences of [[bleeding]] at high doses (According to [[FDA]] total intake up to 3 g per day of [[eicosapentaenoic acid]] (EPA), and [[docosahexaenoic acid]] (DHA) comes under the category of "[[Generally Recognized As Safe]]" (GRAS). Large randomized trials are required to establish the association between [[omega-3 fatty acids]] and bleeding <ref name="pmid16825676">{{cite journal| author=Wang C, Harris WS, Chung M, Lichtenstein AH, Balk EM, Kupelnick B et al.| title=n-3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review. | journal=Am J Clin Nutr | year= 2006 | volume= 84 | issue= 1 | pages= 5-17 | pmid=16825676 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16825676  }} </ref>.
===Sources===
* Fatty fish (salmon,Herring), flaxseed, flaxseed oil, canola oil, soybean oil, and nuts.


===Trial supportive data===
===Trial supportive data===

Revision as of 14:51, 4 October 2011

Template:Hypertriglyceridemia

For full Omega-3 fatty acid drug info click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]

Overview

Treatment of hypertriglyceridemia is by restriction of carbohydrates and fat in the diet, as well as with niacin, fibrates and statins (three classes of drugs). Increased fish oil intake may substantially lower an individual's triglycerides.[1][2][3].

Trial supportive data

Study on effect of combination of Omega-3 fatty acid and Simvastatin on hypertriglyceridemia [4]

  • Source & year – Heart, 2001
  • Study question – An omega-3 polyunsaturated fatty acid concentrate (Omacor) administered for one year decreased triglycerides in simvastatin treated patients with coronary heart disease and persisting hypertriglyceridaemia
  • Study Population and intervention – 59 patients with CHD, receiving simvastatin 10-40 mg daily with serum triglycerides > 2.3 mmol/l, were either given Omacor (84% omega-3 fatty acid) 2 g BD or placebo for 24 weeks
  • Study design – Double blinded randomized controlled trial
  • Study period – 1 year

External links

http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=184

References

  1. ↑ "Lipids Online Slides: hypertriglyceridemia, ICAM-1, fish oil, E-selectin".
  2. ↑ Terres W, Beil U, Reimann B, Tiede S, Bleifeld W (1991). "[Low-dose fish oil in primary hypertriglyceridemia. A randomized placebo-controlled study]". Zeitschrift für Kardiologie (in German). 80 (1): 20–4. PMID 2035283.
  3. ↑ "Fish oils in hypertriglyceridemia - Fish Oils Revisited Nutrition Research Newsletter - Find Articles".
  4. ↑ Durrington PN, Bhatnagar D, Mackness MI, Morgan J, Julier K, Khan MA; et al. (2001). "An omega-3 polyunsaturated fatty acid concentrate administered for one year decreased triglycerides in simvastatin treated patients with coronary heart disease and persisting hypertriglyceridaemia". Heart. 85 (5): 544–8. PMC 1729738. PMID 11303007.


Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Hypertriglyceridemia_omega-3_fatty_acids&oldid=608941"