Omacor in familial combined hyperlipidemia: effects on lipids and low density lipoprotein subclasses
| Autor: | Daniela Donati, Franco Pazzucconi, Laura Calabresi, Cesare R. Sirtori, Guido Franceschini |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male medicine.medical_specialty Apolipoprotein B Docosahexaenoic Acids Hyperlipidemia Familial Combined chemistry.chemical_compound Double-Blind Method Internal medicine Hyperlipidemia medicine Humans Triglycerides Cross-Over Studies biology Cholesterol Middle Aged medicine.disease Eicosapentaenoic acid Crossover study Lipids Lipoproteins LDL Drug Combinations Endocrinology chemistry Eicosapentaenoic Acid Docosahexaenoic acid Low-density lipoprotein biology.protein lipids (amino acids peptides and proteins) Female Cardiology and Cardiovascular Medicine Lipoprotein |
| Zdroj: | Atherosclerosis. 148(2) |
| ISSN: | 0021-9150 |
| Popis: | Elevations of plasma cholesterol and/or triglycerides, and the prevalence of small, dense LDL particles remarkably increase coronary risk in patients with familial combined hyperlipidemia (FCHL). A total of 14 FCHL patients were studied, to investigate the ability of Omacor, a drug containing the n-3 fatty acids eicosapentaenoic and docosahexaenoic acid (EPA and DHA), to favorably correct plasma lipid/lipoprotein levels and LDL particle distribution. The patients received four capsules daily of Omacor (providing 3.4 g EPA+DHA per day) or placebo for 8 weeks in a randomized, double-blind, cross-over study. Omacor significantly lowered plasma triglycerides and VLDL-cholesterol levels, by 27 and 18%, respectively. Total cholesterol did not change but LDL-cholesterol and apolipoprotein B (apoB) concentrations increased by 21 and 6%. As expected, LDL particles were small (diameter=24.9+/-0.3 nm) and apoB-rich (LDL-cholesterol/apoB ratio=1.27+/-0.26) in the selected subjects. After Omacor treatment LDL became enriched in cholesterol (LDL-cholesterol/apoB ratio=1.40+/-0.17), mainly cholesteryl esters, indicating accumulation in plasma of more buoyant and core enriched LDL particles. Indeed, the separation of LDL subclasses by rate zonal ultracentrifugation showed an increase of the plasma concentration of IDL and of the more buoyant, fast floating LDL-1 and LDL-2 subclasses after Omacor, with a parallel decrease in the concentration of the denser, slow floating LDL-3 subclass. However, the average LDL size did not change after Omacor (25.0+/-0.3 nm). The resistance of the small LDL pattern to drug-induced modifications implies that a maximal lipid-lowering effect must be achieved to reduce coronary risk in FCHL patients. |
| Databáze: | OpenAIRE |
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