Effects of prescription omega-3-acid ethyl esters on lipoprotein particle concentrations, apotipoproteins AI and CIII, and lipoprotein-associated phospholipase A2 mass in statin-treated subjects with hypertriglyceridemia
Effects of prescription omega-3-acid ethyl esters on lipoprotein particle concentrations, apotipoproteins AI and CIII, and lipoprotein-associated phospholipase A2 mass in statin-treated subjects with hypertriglyceridemia
复制标题
DOI：
10.1016/j.jacl.2009.08.001
复制
发表时间：
2009-10-01
影响因子：
4.4
通讯作者：
Ballantyne, Christie M.
中科院分区：
文献类型：
--
作者：
Davidson, Michael H.;Maki, Kevin C.;Ballantyne, Christie M.
背景技术背景：处方ω-3-酸乙酯（P-OM 3）通常用于接受他汀类药物治疗的高脂血症患者，这些患者具有致动脉粥样硬化脂蛋白脂质水平的残余增加。到目前为止，关于omega-3脂肪酸消耗对脂蛋白颗粒浓度的影响的信息有限。目的：我们评估了在高脂血症受试者中，在辛伐他汀40 mg/d的持续治疗方案中加入P-OM 3 4 g/d对脂蛋白颗粒（P）的影响。数据分析来自多中心、随机、双盲、安慰剂对照的处方Omega-3与辛伐他汀组合（COMBOS）研究。在8周辛伐他汀导入后，254名受试者接受P-OM 3（n = 122）或安慰剂（n = 132）额外8周。核磁共振波谱法用于评估脂蛋白浓度和大小。结果：与安慰剂相比，P-OM 3降低了平均极低密度脂蛋白（VLDL-P）的大小，增加了低密度脂蛋白颗粒（LDL-P）的大小（P <0.006），而没有改变高密度脂蛋白颗粒（HDL-P）的大小。与安慰剂相比，P-OM 3没有显著改变总VLDL-P或LDL-P浓度，但大VLDL-P和中密度脂蛋白颗粒（IDL-P）浓度降低（两者均P <0.01），大LDL-P浓度升高（P <0.0001）。HDL-P浓度降低（P <0.0001）是由于中HDL-P降低的结果。与安慰剂相比，残余样颗粒胆固醇、Apo CIII和Lp-PLA（2）浓度降低（均P <0.003）。结论：P-OM 3诱导脂蛋白的大小、浓度和组成的变化，这可能与动脉粥样硬化血栓形成过程有关。(C)2009年国家脂质协会。All rights reserved.
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 4 g/d to an ongoing regimen of simvastatin 40 mg/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 < .006 for both) without altering high-density lipoprotein particle (HDL-P) size. P-OM3 did not significantly change total VLDL-P or LDL-P concentrations relative to placebo, but large VLDL-P and intermediate-density lipoprotein particle (IDL-P) concentrations were lowered (P < .01 for both), and the large LDL-P concentration was increased (P < .0001). HDL-P concentration was reduced (P < .0001) as the result of a decrease in medium HDL-P. Remnant-like particle cholesterol, Apo CIII, and Lp-PLA(2) concentrations were reduced compared with placebo (all P < .003).CONCLUSIONS: P-OM3 induces changes in sizes, concentrations, and compositions of lipoproteins that may have relevance for the atherothrombotic process. (C) 2009 National Lipid Association. All rights reserved.