Modification of lipid-related atherosclerosis risk factors by ω3 fatty acid ethyl esters in hypertriglyceridemic patients

The efficacy of ω3 fatty acid ethyl esters was evaluated in 10 mildly hypertriglyceridemic patients in this randomized, placebo-controlled, double-blind, crossover trial. Patients were given capsules (1 per 10 kg body weight) containing 640 mg/g of ω3 fatty acids or an olive oil placebo for two 4-week treatment periods separated by a 1-week washout phase. Plasma lipids, lipoproteins, and apolipoproteins: phospholipid FA composition; the susceptibility to oxidation of the apolipoprotein B-100 containing lipoproteins; and bleeding times were determined at the end of each period. Plasma triglyceride levels were reduced by 37% (P < 0.001), whereas low density lipoprotein cholesterol and the cholesterol content of subfraction 2 of high density lipoproteins increased by 23 and 56%, respectively (both P < 0.02). Changes in plasma lipid parameters and in phospholipid FA patterns occurred rapidly, usually stabilizing within 1 week, and returned to baseline levels within 10 days after stopping supplementation with ω3 fatty acids. Bleeding times were not changed. However, the susceptibility of lipoproteins to oxidation was increased during the ω3 fatty acid period. We conclude that ω3 fatty acid ethyl esters are effective hypotriglyceridemic agents, and that they impact lipoprotein metabolism very quickly. How they may alter the atherogenic process is not clear from this study because some risk factors worsened and other improved.