Fish oils and their possible role in the treatment of cardiovascular diseases treatment of cardiovascular diseases

Semplicini, Andrea; Valle, Roberto

doi:10.1016/0163-7258(94)90017-5

Cited by 27 publications

(5 citation statements)

References 81 publications

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“…Subsequent evaluation of the abstract and methods sections led to exclusion of 46 studies. Reasons for exclusion included the following: publications that did not assess fish oil supplementation (15 articles [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]), nonrandomized studies (11 articles [34][35][36][37][38][39][40][41][42][43][44]), the population had patients without diabetes or patients with type 1 diabetes (8 articles [45][46][47][48][49][50][51][52]), duplicate publications (7 articles [53][54][55][56][57][58][59]), studies that did not include a placebo arm (3 articles [60][61][62]), and 1 study that did not include human subjects (63). The 12-month follow-up report of the Italian Multicenter Fish Oil Study (64) was excluded because it is a nonrandomiz...…”

Section: Search Resultsmentioning

confidence: 99%

Fish oil supplementation in type 2 diabetes: a quantitative systematic review.

et al. 2000

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Abbreviations: DHA, docosahexaenoic acid; EPA, eicosapentaenoic acid; HMG-CoA, 3-hydroxy 3-methylglutaryl CoA.A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many other substances. Fish Oil Supplementation in Type 2 DiabetesA quantitative systematic review R E V I E W A R T I C L EOBJECTIVE -To determine the effects of fish oil supplementation on lipid levels and glycemic control in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS-A comprehensive search of Medline, Embase, Lilacs, the Cochrane Clinical Trials Registry, bibliographies of relevant papers, and expert input updated through September 1998 was undertaken. All randomized placebo-controlled trials were included in which fish oil supplementation was the only intervention in subjects with type 2 diabetes. Three investigators performed data extraction and quality scoring independently with discrepancies resolved by consensus. Eighteen trials including 823 subjects followed for a mean of 12 weeks were included. Doses of fish oil used ranged from 3 to 18 g/day.The outcomes studied were glycemic control and lipid levels.RESULTS -Meta-analysis of pooled data demonstrated a statistically significant effect of fish oil on lowering triglycerides (Ϫ0.56 mmol/l [95% CI Ϫ0.71 to Ϫ0.41]) and raising LDL cholesterol (0.21 mmol/l [0.02 to 0.41]). No statistically significant effect was observed for fasting glucose, HbA 1c , total cholesterol, or HDL cholesterol. The triglyceride-lowering effect and the elevation in LDL cholesterol were most marked in those trials that recruited hypertriglyceridemic subjects and used higher doses of fish oil. Heterogeneity was observed and explained by the recruitment of subjects with baseline hypertriglyceridemia in some studies. CONCLUSIONS R e v i e w s / C o m m e n t a r i e s / P o s i t i o n S t a t e m e n t s 1408DIABETES CARE, VOLUME 23, NUMBER 9, SEPTEMBER 2000 Fish oil in type 2 diabetesOutcome measures and data extraction Study selection, data extraction, and assigning of a quality score were undertaken independently by 3 investigators with discrepancies resolved by consensus. When data were not available in a published report, efforts were made to contact the primary investigators. Data related to the effects of fish oil and placebo on glycemic and lipid outcomes were extracted from each trial. One study reported total glycosylated hemoglobin; a formula was used to convert data to HbA 1c (15). Study quality was assessed using the score developed by Jadad et al. (16), which has a possible range of 0-5, with a cutoff of 2 used to designate studies of high versus low quality. Data analysis and statistical methodsExtracted data were analyzed using the Review Manager 3.1 statistical software developed by the Cochrane Collaboration.A random-effects model was used to pool data. Effect sizes are presented as weighted mean differences with 95% CIs. Heterogeneity was assessed using the 2 method. Publication bias was evaluated using a funnel plot method (1...

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Section: Search Resultsmentioning

confidence: 99%

Fish oil supplementation in type 2 diabetes: a quantitative systematic review.

et al. 2000

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“…The underlying mechanism may be a reduction of the acute phase reaction because the unsaturated fatty acids reduce the oxidant stress, or it may be a result of the decreased aggregation of platelets. Results of dietary studies with fish oil or n‐3 or n‐3 fatty acids are not consistent 33–37. It has been suggested that the favorable effect of fish oil preparations depends on their antioxidant vitamin E content 38…”

Section: Effect Of Diet On Fibrinogen Levelsmentioning

confidence: 99%

Effects of Diet, Drugs, and Genes on Plasma Fibrinogen Levels

Maat¹

2001

Annals of the New York Academy of Sciences

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Plasma levels of fibrinogen have been identified as independent risk predictors of cardiovascular disease. This has greatly increased interest in the regulation of plasma fibrinogen levels. Many demographic and environmental factors are known to affect fibrinogen levels, such as diet, use of several drugs, age, smoking, body mass, gender, physical exercise, race, and season. Additionally, it is also known that genetic factors determine the fibrinogen levels, and also that they determine the response of fibrinogen levels to environmental factors. Estimates, based on twin studies, suggest that 30–50% of the plasma fibrinogen level is genetically determined. The effect of dietary components on plasma fibrinogen levels is modest. Several components have been identified as factors that influence fibrinogen levels. Among those are fish oil, other lipids, and fibers. Dietary components that were expected to have an effect on fibrinogen, but for which no association was observed are black and green tea. Several drugs are known to influence fibrinogen levels, the most studied of which are platelet aggregation inhibiting drugs, such as ticlopidine, and the lipid lowering fibric acid derivatives (fibrates). Both types of drugs decreased the plasma fibrinogen level by about 10%, and bezafibrate lowers fibrinogen even more in patients with diabetes. No clear effect was observed for the HMG‐CoA reductase inhibitors (statins). In the Bezalip study, fibrinogen levels decreased in patients treated with bezafibrate, but this had no clear effect on the risk of cardiovascular disease. This suggests that several mechanisms influence the fibrinogen level and that these mechanisms may contribute differently to cardiovascular disease. Several variations in the fibrinogen genes have been described and especially variations in the promoter region of the fibrinogen β‐gene are interesting, because the synthesis of the fibrinogen Bβ chain is considered to be the rate limiting step in the fibrinogen biosynthesis. In many studies the fibrinogen β‐gene polymorphisms (−455G/A, −148C/T, and BclI) are found to be associated with the plasma levels of fibrinogen. However, they are not associated with the risk of cardiovascular events, although in several studies an association with the severity and progression of atherosclerosis has been reported. It has also been observed frequently that the fibrinogen β‐gene promoter polymorphisms are associated with the response of fibrinogen levels to environmental factors, such as exercise and trauma. In conclusion, plasma fibrinogen levels are regulated by an interesting and complex interplay between environmental and genetic factors.

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“…These fatty acids also affect nuclear mechanisms that change the expression of various genes encoding enzymes involved in lipid metabolism (5). Dietary n-3 fatty acids exert pleiotrophic effects, including triglyceride (TG)-lowering action, which reduce many cardiovascular risk factors in humans (6)(7)(8). N-3 fatty acids reduce plasma TGs by inhibition of VLDL synthesis in the liver and/or stimulation of their catabolism (6,9).…”

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A fish oil diet produces different degrees of suppression of apoB and triglyceride secretion in human apoB transgenic mouse strains

O’Rourke

Huang

2003

Journal of Lipid Research

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Human apolipoprotein B (apoB) transgenic (HuBTg) mouse strains were used to assess genetic effects on the response to fish oil (FO), a source of n-3 fatty acids. A congenic HuBTg strain of the C57BL/6 (B6) background and six F1 HuBTg strains were fed a FO for 2 weeks. Different responses of plasma lipid levels to FO were observed among these strains. In particular, plasma apoB levels changed minimally in FO-fed male B6 HuBTg mice, but increased markedly ( ‫ف‬ 40%) in FO-fed male FVB/NJ (FVB) ؋ B6 F1 HuBTg mice. These strain differences were determined mainly by hepatic apoB secretion rates and were likely regulated by posttranscriptional mechanisms. In addition, plasma triglyceride (TG) levels were reduced (14%) in FO-fed B6 mice, but not in FVB ؋ B6 mice. These strain differences were determined mainly by TG secretion rates, but were not due to differences in hepatic lipogenesis. Hepatic mRNA levels of acyl-CoA oxidase, reflective of peroxisomal ␤ -oxidation rate, were increased in FO-fed B6 but not in FVB ؋ B6 mice, which could account for the difference in TG secretion rates. In summary, differential effects of FO on plasma apoB and TG levels in B6 and FVB ؋ B6 HuBTg mice were associated with strain differences in hepatic apoB and TG secretion and in peroxisomal ␤ -oxidation. -Ko, C., S. M. O'Rourke, and L-S. Huang. A fish oil diet produces different degrees of suppression of apoB and triglyceride secretion in human apoB transgenic mouse strains. J. Lipid Res. 2003Res. . 44: 1946Res. -1955

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Fish oils and their possible role in the treatment of cardiovascular diseases treatment of cardiovascular diseases

Cited by 27 publications

References 81 publications

Fish oil supplementation in type 2 diabetes: a quantitative systematic review.

Fish oil supplementation in type 2 diabetes: a quantitative systematic review.

Effects of Diet, Drugs, and Genes on Plasma Fibrinogen Levels

A fish oil diet produces different degrees of suppression of apoB and triglyceride secretion in human apoB transgenic mouse strains

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