Fish Oil and the Management of Hypertriglyceridemia

Abstract

Hypertriglyceridemia, regarded as one of the independent clinical markers of metabolic syndrome, is a frequently observed disorder that has been shown to be common in the Arab region. Epidemiologic and clinical trials demonstrated that omega-3 fatty acids have the potential to reduce the incidence of cardiovascular disease (CVD); one of the mechanisms by which this effect is achieved is through reducing plasma triglyceride levels. There is strong scientific evidence from human trials that omega-3 fatty acids from either fish or fish oil supplements significantly reduce blood triglyceride levels and these benefits appear to be dose-dependent. The active ingredients of fish oils include the long chain fatty acids EPA and DHA. The ideal amount of omega-3 fatty acid that should be incorporated into the diet without provoking detrimental effects on other lipid components such as decreasing HDL-C and/or increasing LDL-C has not yet been elucidated. Presently, a prescription form of omega-3 fatty acid has been approved by the United States Food and Drug Administration (USFDA) as an adjunct to the diet for the treatment of very high triglyceride levels (> or = 500 mg/dl) in adults. Patients with hypertriglyceridemia have been shown to respond well to the use of omega-3 fatty acids even when used in conjunction with statins where greater improvements in the lipid profile were found as compared to treatment with statins alone. A determinant of the responsiveness to fish oil could be attributed to the ApoE genotype of individuals.

Evidence of Lifestyle Modification in the Management of Hypercholesterolemia

“…Epidemiologic studies demonstrate reductions in the incidence of nonfatal myocardial infarction and ischemic stroke [48]. There is variation in the effects of omega oils, however an individual’s responsiveness to fish oil could be attributed to his/her ApoE genotype [49]. Small studies have shown fish oils help to slightly lower blood pressure as well as having anti-arrhythmic properties [50-53].…”

Getting personal: considering variable interindividual responsiveness to dietary lipid-lowering therapies

“…Marine-derived omega 3 (n À 3) fatty acids, including eicosapentaenoic (20 : 5n À 3, EPA) and docosahexaenoic acid (22 : 6n À 3, DHA) have been repeatedly demonstrated to reduce circulating TAG concentrations with an associated increase in LDL-C in the range of 5-10% [14]. However, the LDL-C-raising response to fish oil consumption has a significant degree of interindividual variability [6].…”

Effects of nutraceuticals on prevalence of metabolic syndrome and on calculated Framingham Risk Score in individuals with dyslipidemia

“…For instance, patients with hypertriglyceridemia have been shown to successfully respond to the use of omega-3 fatty acids even when used in conjunction with statins, with a consequence of an improvement in the lipid profile greater than with statins alone [1].…”