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Cited by 34Fatty Acid Research and HealthHIV-related health complications and treatmentsLipoproteins and Cardiovascular Health

Omega‐3 fatty acid therapy reduces triglycerides and interleukin‐6 in hypertriglyeridemic HIV patients

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Metkus, TS, Timpone, J, Leaf, D, Goetz, M Bidwell, Harris, WS, Brown, TT·2013·HIV Medicine
DOI 10.1111/hiv.12046PMC PMC4520391
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Abstract

Objectives: Cardiovascular disease and osteoporosis are common in HIV‐infected patients and residual systemic inflammation is thought to contribute to both of these disorders. We performed a randomized placebo‐controlled trial of omega‐3‐acid (O3A) ethyl esters in HIV‐infected patients with hypertriglyceridaemia, hypothesizing that O3A would decrease serum levels of triglycerides, markers of systemic inflammation, and markers of bone turnover. Methods: HIV‐infected patients (n = 48 recruited at three sites) with CD4 count >200 cells/μL, suppressed viral load, and triglycerides >200 mg/dL were randomized to placebo or 3.6 g/d of O3A. Fasting lipid profiles and markers of inflammation and bone turnover were assessed at baseline and after 8 weeks of treatment. Results: Baseline HIV status, lipid profile, bone metabolism and cardiovascular risk factors were similar between the groups. Inflammatory markers were similar between the treatment groups at baseline, except for interleukin (IL)‐6 and tumour necrosis factor (TNF)‐α, which were higher in the O3A group. The concentration of triglycerides in patients receiving O3A decreased by a median (interquartile range (IQR)) of −34 (−149, 9.5) mg/dL vs. a median increase of 46.5 (−51, 123) mg/dL in the placebo group (P = 0.01). The median percentage change in IL‐6 was greater in the O3A group compared with the placebo group [−39% (−63, 12%) vs. 29% (10, 177%), respectively; P = 0.006]. Similar results were observed for TNF‐α, but not other inflammatory or bone turnover markers. Conclusions: O3A ethyl esters decreased the concentrations of triglycerides, IL‐6 and TNF‐α in patients with well‐controlled HIV infection and hypertriglyceridaemia. Larger studies are required to confirm these findings and investigate their clinical significance.

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  • IPE lowered non-HDL-C by 14% and apo B by 9%.

    “IPE lowered non-HDL-C by 14% (control, 9.8%; active, -5.5%) and apo B by 9% (control, 7%; active, -2.2%).36”

    From Omega-3 Fatty Acids for the Management of Hypertriglyceridemia: A Science Advisory From the American Heart Association (2019) · cites this paper as [36]

    The Methods (Treatment; page unavailable) identify the intervention as Lovaza, an EPA/DHA mixture, not IPE. The Results (Effect of O3A ethyl esters on lipid parameters; page unavailable) report no difference between groups in non-HDL cholesterol or other lipid parameters apart from triglycerides. The copy does not report an apo B reduction or the cited percentages. (LLM, conf=0.88)

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  • The placebo-corrected LDL-C effect of 4 g/d IPE was -6% (control 8.8%; active 2%).

    “The placebo-corrected LDL-C effect of 4 g/d IPE was -6% (control, 8.8%; active, 2%).36”

    From Omega-3 Fatty Acids for the Management of Hypertriglyceridemia: A Science Advisory From the American Heart Association (2019) · cites this paper as [36]

    The Methods (Treatment; page unavailable) identify the active treatment as Lovaza, a mixture of EPA and DHA, not IPE. The Results (Effect of O3A ethyl esters on lipid parameters; page unavailable) report no between-group difference in LDL cholesterol and do not report the claimed −6%, 8.8%, or 2% LDL-C figures. (LLM, conf=0.88)

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  • In patients with hypertriglyceridemia, 4 g/d O3AEE produced greater triglyceride reduction (20%-30%) than 2 g/d (11%-15% or no significant reduction).

    “In studies of O3AEE in patients with HTG, 4 g/d (3.4 g/d EPA+DHA) has demonstrated greater efficacy (20%-30% reduction) than the 2-g/d dose (1.7 g/d EPA+DHA), which resulted in modest reductions of 11% to 15% 50,67 or no significant triglyceride reduction.36,68”

    From Omega-3 Fatty Acids for the Management of Hypertriglyceridemia: A Science Advisory From the American Heart Association (2019) · cites this paper as [36]

    The Methods (Treatment; page unavailable) report four 1000-mg omega-3 capsules daily, and the Results (Effect of O3A ethyl esters on lipid parameters; page unavailable) report a statistically significant triglyceride reduction. The median reduction was 9% in the active-treatment group; the Discussion describes it as 24% versus placebo. This study did not test a 2-g/day dose or establish the claimed comparison between doses. (LLM, conf=0.85)

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Cites

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Authors
Metkus, T., Timpone, J., Leaf, D., Goetz, M. B., Harris, W., & Brown, T.
Affiliations
  • Johns Hopkins University (US)
  • Georgetown University (US)
  • United States Department of Veterans Affairs (US)
  • Division of Infectious Diseases Veterans Administration Medical Center Los Angeles CA USA
  • University of South Dakota (US)
  • Division of Endocrinology and Metabolism Johns Hopkins University Baltimore MD USA
ORCID
Goetz, M Bidwell
Venue
HIV Medicine
Publisher
Wiley
Published
2013-05-19
Volume
14
Issue
9
Pages
530-539
ISSN
  • 1464-2662 (ISSN-L)
  • 1468-1293
DOI
10.1111/hiv.12046
PMC
PMC4520391
OpenAlex
W1925234239
Cited by
34
References
4
Citations by year
2026: 3 · 2024: 2 · 2023: 1 · 2022: 3 · 2020: 6 · 2019: 3 · 2018: 1 · 2017: 5 · 2016: 2 · 2015: 6 · 2014: 2
FWCI
3.09
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • HIV Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • GlaxoSmithKline
  • Johns Hopkins University
  • National Center for Research Resources (UL1RR025005, TL1RR025007)
  • National Center for Complementary and Integrative Health (K23AT002862)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
  • Health Sciences › Medicine › Emergency Medicine › HIV-related health complications and treatments
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
Keywords
omega-3 fatty acids, ethyl esters, hypertriglyceridemia, HIV infection, triglycerides, interleukin-6, TNF-α, systemic inflammation, bone turnover, cardiovascular risk, osteoporosis
MeSH terms
Adult, Cardiovascular Diseases, Female, Humans, Inflammation, Male, Middle Aged, Osteoporosis, Triglycerides, Hypertriglyceridemia, Biomarkers, Fatty Acids, Omega-3, HIV Infections, Interleukin-6

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