Limited Impact of 2 g/day Omega-3 Fatty Acid Ethyl Esters (Omacor®) on Plasma Lipids and Inflammatory Markers in Patients Awaiting Carotid Endarterectomy

Abstract

The objective of this study was to determine the effects of prescription omega-3 (n-3) fatty acid ethyl esters (Omacor®) on blood pressure, plasma lipids, and inflammatory marker concentrations in patients awaiting carotid endarterectomy. Patients awaiting carotid endarterectomy (n = 121) were randomised to Omacor® or olive oil as placebo (2 g/day) until surgery (median 21 days). Blood pressure, plasma lipids, and plasma inflammatory markers were determined. There were significant decreases in systolic and diastolic blood pressure and in plasma triglyceride, total cholesterol, low density lipoprotein-cholesterol, soluble vascular cellular adhesion molecule 1, and matrix metalloproteinase 2 concentrations, in both groups. The extent of triglyceride lowering was greater with Omacor® (25%) compared with placebo (9%). Soluble E-selectin concentration was significantly decreased in the Omacor® group but increased in the placebo group. At the end of the supplementation period there were no differences in blood pressure or in plasma lipid and inflammatory marker concentrations between the two groups. It is concluded that Omacor® given at 2 g/day for an average of 21 days to patients with advanced carotid atherosclerosis lowers triglycerides and soluble E-selectin concentrations, but has limited broad impact on the plasma lipid profile or on inflammatory markers. This may be because the duration of intervention was too short or the dose of n-3 fatty acids was too low.

Effect of long chain omega-3 polyunsaturated fatty acids on inflammation and metabolic markers in hypertensive and/or diabetic obese adults: a randomized controlled trial

“…Similarly, the study by Yusof et al ( 33 ) did not result in effective reduction by supplementing 888 mg EPA and 777 mg DHA daily for 21 days on patients of carotid endarterectomy. As well, Mackay et al ( 35 ) did not detect reduction of IL-6 in experimental group (850 mg EPA and 882 mg DHA for 6 weeks) in patients with intermittent claudication.…”

“…All metabolic markers reduced significantly in the experimental group, while no significant reduction was detected in the placebo group. Furthermore, Yusof et al ( 33 ) proved a positive effect of PUFAs on lipid profile markers in RCT of carotid endarterectomy patients.…”

“…On the contrary, an insignificant change in hs-CRP was observed in the experimental groups. For instance, Yusof et al ( 33 ) conducted a placebo RCT for 100 patients of carotid endarterectomy; experimental group (47 patients) received 888 mg EPA and 777 mg DHA daily, whereas control group (53 patients) received 2 g of olive oil capsule daily for 21 days. The study obtained no significant change in hs-CRP due to intervention of EPA/DHA in the experimental group.…”

Omega-3 fatty acids for breast cancer prevention and survivorship

“…Human studies in inflammatory disorders show little evidence of a systemic anti-inflammatory effect such as reduction of cytokines or prostaglandin E 2 levels with doses of combined EPA + DHA less than ~3.5 g/day and/or EPA-alone doses <2.7 g/day [ 26 , 64 ]. However, experts in this area suggest that systemic measures of cytokines in inflammatory conditions are likely to be insensitive compared with measuring conditions in the tissue of interest [ 65 ].…”

Fish Oil Decreases Hepatic Lipogenic Genes in Rats Fasted and Refed on a High Fructose Diet

“…Omega-3 ( n -3) polyunsaturated fatty acids are known to modulate hepatic gene expression resulting in increased β-oxidation and decreased lipogenesis, effects mediated through PPAR-α and its target genes [ 4 ]. Consequently n -3 fatty acids are able to decrease plasma TAG concentrations [ 5 , 6 ] with subsequent improvements in cardiovascular morbidity and mortality, and in other inflammatory conditions [ 7 , 8 ]. Fish oil (FO) is a rich source of the main bioactive n -3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).…”