Abstract
Background and aims
The well-established triglyceride (TG) lowering effect of fish oil is accompanied
by an increase in LDL-cholesterol (LDL-C) concentration. Less is known about the differential
impact on LDL particle distribution – the smaller particles being associated with
a greater risk for atherosclerosis. We aimed to examine the changes in serum concentrations
of four subclasses of LDL particles as well as shifts in LDL phenotype patterns (A,
B, AB) among hypertriglyceridemic adults.
Methods and results
This was a secondary analysis from a double-blind, parallel design, placebo controlled
trial with 42 adults that experienced significant TG lowering and modest increases
in total LDL-C concentrations after 12 weeks of 4 g/d EPA + DHA. Reduction in serum
TG concentrations (mean ± SEM) was −26 ± 4% (−0.81 ± 10.12 mmol/L), p < 0.0001. Total LDL-C concentration increased by 13 ± 3% (+0.31 ± 0.08 mmol/L), p < 0.0001. The 12-week changes in concentrations of LDL1, LDL2, LDL3 and LDL4 were
+0.06 ± 0.02 mmol/L [+2.2 ± 0.7 mg/dL], +0.07 ± 0.03 mmol/L [+2.6 ± 1.0 mg/dL], +0.16 ± 0.05 mmol/L
[+6.3 ± 1.8 mg/dL], and +0.04 ± 0.04 mmol/L [+1.4 ± 1.7 mg/dL], respectively (+20 ± 5%,
+64 ± 13%, +26 ± 6%, and +17 ± 9%), p < 0.05 for all but LDL4. Changes in LDL phenotype patterns A, B and A/B were negligible
and not statistically significant.
Conclusion
In this population of hypertriglyceridemic adults, dietary supplementation with fish
oil resulted in an increase in total LDL-C concentration which was distributed relatively
evenly across the range of smaller and more atherogenic as well as larger and less
atherogenic LDL particles.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Nutrition, Metabolism and Cardiovascular DiseasesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey.JAMA. 2002; 287 (jbr10281 [pii]): 356-359
- Hypertriglyceridemia and its pharmacologic treatment among US adults.Arch Intern Med. 2009; 169 (169/6/572 [pii] 10.1001/archinternmed.2008.599): 572-578
- Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: diet and reinfarction trial (DART).Lancet. 1989; 2 (S0140-6736(89)90828-3 [pii]): 757-761
- Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico.Lancet. 1999; 354 (S0140673699070725 [pii]): 447-455
- Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease.Circulation. 2002; 106: 2747-2757
- N-3 fatty acids and serum lipoproteins: human studies.Am J Clin Nutr. 1997; 65: 1645S-1654S
- Dietary supplementation with marine omega-3 fatty acids improve systemic large artery endothelial function in subjects with hypercholesterolemia.J Am Coll Cardiol. 2000; 35 (S0735-1097(99)00548-3 [pii]): 265-270
- Will the rising tide of Rx Omega-3s float the fish oil supplement market? FDC reports.The Tan Sheet. 2011; 19: 5
- Association of small low-density lipoprotein particles with the incidence of coronary artery disease in men and women.JAMA. 1996; 276: 875-881
- A prospective study of triglyceride level, low-density lipoprotein particle diameter, and risk of myocardial infarction.JAMA. 1996; 276: 882-888
- Small dense low density lipoprotein has increased affinity for LDL receptor-independent cell surface binding sites: a potential mechanism for increased atherogenicity.J Lipid Res. 1998; 39: 1263-1273
- Discrete subspecies of human low density lipoproteins are heterogeneous in their interaction with the cellular LDL receptor.J Lipid Res. 1991; 32: 1741-1753
- Enhanced susceptibility to in vitro oxidation of the dense low density lipoprotein subfraction in healthy subjects.Arterioscler Thromb. 1991; 11: 298-306
- Differential effects of eicosapentaenoic acid and docosahexaenoic acid on vascular reactivity of the forearm microcirculation in hyperlipidemic, overweight men.Circulation. 2000; 102: 1264-1269
- Low-density-lipoprotein subclasses and response to a low-fat diet in healthy men.Am J Clin Nutr. 1995; 62: 478S-487S
- Effects of altering the ratio of dietary n-6 to n-3 fatty acids on insulin sensitivity, lipoprotein size, and postprandial lipemia in men and postmenopausal women aged 45-70 y: the OPTILIP Study.Am J Clin Nutr. 2006; 84 (84/6/1290 [pii]): 1290-1298
- Docosahexaenoic acid supplementation improves fasting and postprandial lipid profiles in hypertriglyceridemic men.Am J Clin Nutr. 2007; 86 (86/2/324 [pii]): 324-333
- The effect of concentrated n-3 fatty acids versus gemfibrozil on plasma lipoproteins, low density lipoprotein heterogeneity and oxidizability in patients with hypertriglyceridemia.Atherosclerosis. 2000; 153 (S0021915000003816 [pii]): 129-138
- (n-3) fatty acid supplementation in moderately hypertriglyceridemic adults changes postprandial lipid and apolipoprotein B responses to a standardized test meal.J Nutr. 1999; 129: 1126-1134
- Effects of fish oil fatty acids on low density lipoprotein size, oxidizability, and uptake by macrophages.J Lipid Res. 1995; 36: 473-484
- Effect of pravastatin and omega-3 fatty acids on plasma lipids and lipoproteins in patients with combined hyperlipidemia.Arterioscler Thromb. 1993; 13: 1755-1762
- Effects of dietary saturated, monounsaturated and n-3 fatty acids on fasting lipoproteins, LDL size and post-prandial lipid metabolism in healthy subjects.Atherosclerosis. 2003; 167 (S0021915002004240 [pii]): 149-158
- Lack of effect of cold water prawns on plasma cholesterol and lipoproteins in normo-lipidaemic men.Cell Mol Biol (Noisy-le-grand). 2010; 56: 52-58
- Independent and interactive effects of plant sterols and fish oil n-3 long-chain polyunsaturated fatty acids on the plasma lipid profile of mildly hyperlipidaemic Indian adults.Br J Nutr. 2009; 102 (S0007114509297170 [pii] 10.1017/S0007114509297170): 722-732
- Effects of marine n-3 fatty acid supplementation on lipoprotein subclasses measured by nuclear magnetic resonance in subjects with type II diabetes.Eur J Clin Nutr. 2008; 62 (1602703 [pii] 10.1038/sj.ejcn.1602703): 419-429
- Effects of a Mediterranean-inspired diet on blood lipids, vascular function and oxidative stress in healthy subjects.Clin Sci (Lond). 2004; 106 ([pii]): 519-525https://doi.org/10.1042/CS20030315 CS20030315
- Peroxidation of LDL from combined-hyperlipidemic male smokers supplied with omega-3 fatty acids and antioxidants.Arterioscler Thromb Vasc Biol. 1997; 17: 2576-2588
- 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 (S0021915099001495 [pii]): 361-367
- Effects of n-3 fatty acids in subjects with type 2 diabetes: reduction of insulin sensitivity and time-dependent alteration from carbohydrate to fat oxidation.Am J Clin Nutr. 2006; 84 (84/3/540 [pii]): 540-550
- Effects of eicosapentaenoic acid on plasma lipoprotein subfractions and activities of lecithin:cholesterol acyltransferase and lipid transfer protein.Atherosclerosis. 1991; 91: 145-153
- Assessment of habitual physical activity by a seven-day recall in a community survey and controlled experiments.Am J Epidemiol. 1985; 122: 794-804
- Cholesterol profile measurement by vertical auto profile method.Clin Lab Med. 2006; 26 (S0272-2712(06)00074-6 [pii] 10.1016/j.cll.2006.07.004): 787-802
- Atherogenic lipoprotein phenotype. A proposed genetic marker for coronary heart disease risk.Circulation. 1990; 82: 495-506
- Omega-3 fatty acids in cardiac biopsies from heart transplantation patients: correlation with erythrocytes and response to supplementation.Circulation. 2004; 110 ([pii]): 1645-1649https://doi.org/10.1161/01.CIR.0000142292.10048.B2 01.CIR.0000142292.10048.B2
- Effects of omega-3 fatty acids on serum markers of cardiovascular disease risk: a systematic review.Atherosclerosis. 2006; 189 (S0021-9150(06)00069-4 [pii] 10.1016/j.atherosclerosis.2006.02.012): 19-30
- ApoE polymorphism and fish oil supplementation in subjects with an atherogenic lipoprotein phenotype.Arterioscler Thromb Vasc Biol. 2000; 20: 1990-1997
- Omacor in familial combined hyperlipidemia: effects on lipids and low density lipoprotein subclasses.Atherosclerosis. 2000; 148 (S0021915099002671 [pii]): 387-396
- Potential impact of omega-3 treatment on cardiovascular disease in type 2 diabetes.Curr Opin Lipidol. 2009; 20: 30-38
- Mechanism for the increase in plasma triacylglycerol concentrations after consumption of short-term, high-carbohydrate diets.Am J Clin Nutr. 2001; 73: 892-899
- Suppression by diets rich in fish oil of very low density lipoprotein production in man.J Clin Invest. 1984; 74: 82-89https://doi.org/10.1172/JCI111422
- Determinants of LDL subfraction distribution and concentrations in young normolipidemic subjects.Arterioscler Thromb. 1994; 14: 902-910
- LDL subclass phenotypes and the insulin resistance syndrome in women.Circulation. 1993; 88: 381-387
Article info
Publication history
Published online: September 19, 2011
Accepted:
June 23,
2011
Received in revised form:
June 16,
2011
Received:
February 28,
2011
Identification
Copyright
© 2011 Published by Elsevier Inc.
