Diabetes Metab J.  2013 Jun;37(3):207-211. 10.4093/dmj.2013.37.3.207.

Beneficial Effects of Omega-3 Fatty Acids on Low Density Lipoprotein Particle Size in Patients with Type 2 Diabetes Already under Statin Therapy

Affiliations
  • 1Department of Endocrinology, Gwangmyeong Sung Ae Hospital, Gwangmyeong, Korea.
  • 2Department of Endocrinology, Good Morning Hospital, Pyeongtaek, Korea.
  • 3Division of Endocrinology, Institute of Endocrine Research, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. ejlee423@yuhs.ac
  • 4Department of Endocrinology and Metabolism, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 5Department of Endocrinology and Metabolism, National Health Insurance Cooperation Ilsan Hospital, Goyang, Korea.
  • 6Dr.Cho's Internal Medicine Clinic, Seoul, Korea.
  • 7Department of Endocrinology and Metabolism, CHA Bundang Medical Center, CHA University, Seongnam, Korea. spark@cha.ac.kr

Abstract

Beyond statin therapy for reducing low density lipoprotein cholesterol (LDL-C), additional therapeutic strategies are required to achieve more optimal reduction in cardiovascular risk among diabetic patients with dyslipidemia. To evaluate the effects and the safety of combined treatment with omega-3 fatty acids and statin in dyslipidemic patients with type 2 diabetes, we conducted a randomized, open-label study in Korea. Patients with persistent hypertriglyceridemia (> or =200 mg/dL) while taking statin for at least 6 weeks were eligible. Fifty-one patients were randomized to receive either omega-3 fatty acid 4, 2 g, or no drug for 8 weeks while continuing statin therapy. After 8 weeks of treatment, the mean percentage change of low density lipoprotein (LDL) particle size and triglyceride (TG) level was greater in patients who were prescribed 4 g of omega-3 fatty acid with statin than in patients receiving statin monotherapy (2.8%+/-3.1% vs. 2.3%+/-3.6%, P=0.024; -41.0%+/-24.1% vs. -24.2%+/-31.9%, P=0.049). Coadministration of omega-3 fatty acids with statin increased LDL particle size and decreased TG level in dyslipidemic patients with type 2 diabetes. The therapy was well tolerated without significant adverse effects.

Keyword

Diabetes mellitus, type 2; Dyslipidemia; Fatty acids, omega-3; Hypertriglyceridemia; Low density lipoprotein particle

MeSH Terms

Cholesterol
Cholesterol, LDL
Diabetes Mellitus, Type 2
Dyslipidemias
Fatty Acids, Omega-3
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Hypertriglyceridemia
Korea
Lipoproteins
Particle Size
Cholesterol
Cholesterol, LDL
Fatty Acids, Omega-3
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Lipoproteins

Figure

  • Fig. 1 (A) Mean low density lipoprotein (LDL) particle size at baseline and at week 8, using Wilcoxon signed rank test (for O3FA4S and O3FA2S group) or paired t-test (for statin only group). (B) Mean percentage changes in LDL particle size from baseline to week 8, using analysis of covariance. O3FA4S group, 4 g of omega-3 fatty acid and statin; O3FA2S group, 2 g of omega-3 fatty acid and statin; Statin group, statin monotherapy; NS, not significant. aP<0.01, bP<0.05.


Cited by  3 articles

Efficacy and Safety of Omega-3 Fatty Acids in Patients Treated with Statins for Residual Hypertriglyceridemia: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
Ji Eun Jun, In-Kyung Jeong, Jae Myung Yu, Sung Rae Kim, In Kye Lee, Kyung-Ah Han, Sung Hee Choi, Soo-Kyung Kim, Hyeong Kyu Park, Ji-Oh Mok, Yong-ho Lee, Hyuk-Sang Kwon, So Hun Kim, Ho-Cheol Kang, Sang Ah Lee, Chang Beom Lee, Kyung Mook Choi, Sung-Ho Her, Won Yong Shin, Mi-Seung Shin, Hyo-Suk Ahn, Seung Ho Kang, Jin-Man Cho, Sang-Ho Jo, Tae-Joon Cha, Seok Yeon Kim, Kyung Heon Won, Dong-Bin Kim, Jae Hyuk Lee, Moon-Kyu Lee
Diabetes Metab J. 2020;44(1):78-90.    doi: 10.4093/dmj.2018.0265.

The combination of canagliflozin and omega-3 fatty acid ameliorates insulin resistance and cardiac biomarkers via modulation of inflammatory cytokines in type 2 diabetic rats
Mohammed Mohsen Safhi, Tarique Anwer, Gyas Khan, Rahimullah Siddiqui, Sivagurunathan Moni Sivakumar, Mohammad Firoz Alam
Korean J Physiol Pharmacol. 2018;22(5):493-501.    doi: 10.4196/kjpp.2018.22.5.493.

Omega-3 Polyunsaturated Fatty Acids May Attenuate Streptozotocin-Induced Pancreatic β-Cell Death via Autophagy Activation in Fat1 Transgenic Mice
Won-Min Hwang, Dong-Ho Bak, Dong Ho Kim, Ju Young Hong, Seung-Yun Han, Keun-Young Park, Kyu Lim, Dong-Mee Lim, Jae Gu Kang
Endocrinol Metab. 2015;30(4):569-575.    doi: 10.3803/EnM.2015.30.4.569.


Reference

1. Libby P. The forgotten majority: unfinished business in cardiovascular risk reduction. J Am Coll Cardiol. 2005; 46:1225–1228.
2. Ford ES, Li C, Zhao G, Pearson WS, Mokdad AH. Hypertriglyceridemia and its pharmacologic treatment among US adults. Arch Intern Med. 2009; 169:572–578.
3. Bays H. Clinical overview of Omacor: a concentrated formulation of omega-3 polyunsaturated fatty acids. Am J Cardiol. 2006; 98(4A):71i–76i.
4. Jialal I, Amess W, Kaur M. Management of hypertriglyceridemia in the diabetic patient. Curr Diab Rep. 2010; 10:316–320.
5. Bitzur R, Cohen H, Kamari Y, Shaish A, Harats D. Triglycerides and HDL cholesterol: stars or second leads in diabetes? Diabetes Care. 2009; 32:Suppl 2. S373–S377.
6. Brunzell JD, Davidson M, Furberg CD, Goldberg RB, Howard BV, Stein JH, Witztum JL. American Diabetes Association. American College of Cardiology Foundation. Lipoprotein management in patients with cardiometabolic risk: consensus statement from the American Diabetes Association and the American College of Cardiology Foundation. Diabetes Care. 2008; 31:811–822.
7. Rosenson RS, Carlson DM, Kelly MT, Setze CM, Hirshberg B, Stolzenbach JC, Williams LA. Achievement of lipid targets with the combination of rosuvastatin and fenofibric acid in patients with type 2 diabetes mellitus. Cardiovasc Drugs Ther. 2011; 25:47–57.
8. Calabresi L, Donati D, Pazzucconi F, Sirtori CR, Franceschini G. Omacor in familial combined hyperlipidemia: effects on lipids and low density lipoprotein subclasses. Atherosclerosis. 2000; 148:387–396.
9. Patti L, Maffettone A, Iovine C, Marino LD, Annuzzi G, Riccardi G, Rivellese AA. Long-term effects of fish oil on lipoprotein subfractions and low density lipoprotein size in non-insulin-dependent diabetic patients with hypertriglyceridemia. Atherosclerosis. 1999; 146:361–367.
10. Rivellese AA, Maffettone A, Iovine C, Di Marino L, Annuzzi G, Mancini M, Riccardi G. Long-term effects of fish oil on insulin resistance and plasma lipoproteins in NIDDM patients with hypertriglyceridemia. Diabetes Care. 1996; 19:1207–1213.
11. Petersen M, Pedersen H, Major-Pedersen A, Jensen T, Marckmann P. Effect of fish oil versus corn oil supplementation on LDL and HDL subclasses in type 2 diabetic patients. Diabetes Care. 2002; 25:1704–1708.
12. Boizel R, Benhamou PY, Lardy B, Laporte F, Foulon T, Halimi S. Ratio of triglycerides to HDL cholesterol is an indicator of LDL particle size in patients with type 2 diabetes and normal HDL cholesterol levels. Diabetes Care. 2000; 23:1679–1685.
13. Park Y, Harris WS. Omega-3 fatty acid supplementation accelerates chylomicron triglyceride clearance. J Lipid Res. 2003; 44:455–463.
14. Levy E, Spahis S, Ziv E, Marette A, Elchebly M, Lambert M, Delvin E. Overproduction of intestinal lipoprotein containing apolipoprotein B-48 in Psammomys obesus: impact of dietary n-3 fatty acids. Diabetologia. 2006; 49:1937–1945.
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