Effects of prescription omega-3-acid ethyl esters on lipoprotein particle concentrations, apolipoproteins AI and CIII, and lipoprotein-associated phospholipase A2 mass in statin-treated subjects with hypertriglyceridemia
Abstract
Background Prescription omega-3-acid ethyl esters (P-OM3) often are used for hypertriglyceridemic patients receiving statin therapy who have residual increases in atherogenic lipoprotein lipid levels. To date, limited information has been published regarding the effects of omega-3 fatty acid consumption on lipoprotein particle concentrations. Objective We evaluated the effects of adding P-OM3 4g/d to an ongoing regimen of simvastatin 40mg/d on lipoprotein particles (P) in subjects with hypertriglyceridemia. Methods Data were analyzed from the multicenter, randomized, double-blind, placebo-controlled Combination of Prescription Omega-3s with Simvastatin (COMBOS) study. After an 8-week simvastatin lead-in, 254 subjects received P-OM3 (n=122) or placebo (n=132) for an additional 8 weeks. Nuclear magnetic resonance spectroscopy was used to assess lipoprotein concentrations and sizes. Remnant-like particle cholesterol, apolipoprotein (Apo) CIII, Apo AI, and lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) levels also were measured. Results Compared with placebo, P-OM3 reduced mean very-low-density lipoprotein (VLDL-P) size and increased low-density lipoprotein particle (LDL-P) size (P Conclusions P-OM3 induces changes in sizes, concentrations, and compositions of lipoproteins that may have relevance for the atherothrombotic process.
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The Apo CIII reduction with OM3-FFA is consistent with prior findings of reduced Apo CIII after EPA plus DHA ingestion.
“This is consistent with prior findings of reduced Apo CIII after ingestion of EPA 1 DHA.”
From Omega-3 free fatty acids for the treatment of severe hypertriglyceridemia: The EpanoVa fOr Lowering Very high triglyceridEs (EVOLVE) trial (2014) · cites this paper as [34]
The net effect of OM3-FFA was to reduce cholesterol carried by atherogenic particles, as measured by non-HDL-C.
“the net effect was to reduce the amount of cholesterol carried by such particles (non-HDL-C), which is consistent with results from studies of EPA 1 DHA-EE.”
From Omega-3 free fatty acids for the treatment of severe hypertriglyceridemia: The EpanoVa fOr Lowering Very high triglyceridEs (EVOLVE) trial (2014) · cites this paper as [34]
The effect of omega-3 therapy adds to the effect of statin treatment.
“the effect of OM3 therapy is additive to that of statin treatment.34,35”
From Omega-3 free fatty acids for the treatment of severe hypertriglyceridemia: The EpanoVa fOr Lowering Very high triglyceridEs (EVOLVE) trial (2014) · cites this paper as [34]
Earlier studies of omega-3 ethyl esters found lower lipoprotein-associated phospholipase A2.
“Previous studies with OM3-EEs have also shown reduced Lp-PLA 2 ,”
From Omega-3 free fatty acids for the treatment of severe hypertriglyceridemia: The EpanoVa fOr Lowering Very high triglyceridEs (EVOLVE) trial (2014) · cites this paper as [34]
Earlier trials of EPA and DHA ethyl esters generally found no change in high-sensitivity C-reactive protein.
“In general, prior studies of EPA 1 DHA-EE treatments have reported no change in hs-CRP.34,35”
From Omega-3 free fatty acids for the treatment of severe hypertriglyceridemia: The EpanoVa fOr Lowering Very high triglyceridEs (EVOLVE) trial (2014) · cites this paper as [34]
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- Authors
- Davidson, M. H., Maki, K. C., Bays, H., Carter, R., & Ballantyne, C. M.
- Affiliations
- University of Chicago (US)
- Louisville Metabolic and Atherosclerosis Research Center (US)
- Baylor College of Medicine (US)
- Corresponding author
- Davidson, Michael H.
- Venue
- Journal of Clinical Lipidology
- Publisher
- Elsevier BV
- Published
- 2009-10
- Volume
- 3
- Issue
- 5
- Pages
- 332-340
- ISSN
- 1876-4789 (ISSN-L)
- 1933-2874
- OpenAlex
- W2066530607
- Cited by
- 71
- References
- 43
- Citations by year
- 2026: 2 · 2025: 1 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 4 · 2017: 4 · 2016: 9 · 2015: 13 · 2014: 4 · 2013: 8 · 2012: 5
- FWCI
- 5.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of clinical lipidology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Keywords
- hypertriglyceridemia, simvastatin, statin therapy, lipoprotein particle size, remnant-like particle cholesterol, apolipoprotein C-III, apolipoprotein A-I, lipoprotein-associated phospholipase A2, VLDL, intermediate density lipoprotein, HDL particle size
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