• Effect of n-3 Fatty Acid Supplementation in Hyperlipidemic Patients Taking Statins on Lipid Profile, Including Small Dense LDL: A Randomized Controlled Trial

      Mushtaq, Sohail; Dogay, Gediz (University of Chester, 2017-10)
      Background: Epidemiological and clinical evidence suggests that high-dose intake of long-chain OM-3 FA have a favourable role in altering blood TAG and non-HDL-C when combined with statins in hyperlipidemic patients. Their efficacy in altering LDL-C particle size and concentration is yet to be confirmed. Aim: This study evaluated the effects of adding 4/day EPA+DHA to stable statin therapy on non-HDL-C, TAG, HDL-C, LDL-C and small&dense LDL-C particle concentration in a group of hyperlipidemic patients. Methods: In this randomized, placebo-controlled, double-blind parallel group study, 44 subjects who were already on statin therapy for >8 weeks and had non-HDL-C levels above the National Lipid Association Recommendations were randomized into two groups. For 8 weeks, together with their prescribed atorvastatin, the intervention group received 4 g/day EPA+DHA (in ethyl ester form) while the control group received 4 g/day olive oil (placebo). Baseline measurements of non-HDL-C, TAG, TC, HDL-C, LDL-C, VLDL-C and LDL-C particle concentration were repeated at week 8. Differences in dietary intake was assessed with a weighted 3-day food diary at week 4. Primary outcome measures were the percent change in LDL-C III non-HDL-C and particle concentration from baseline. Results: At the end of treatment, the median percent change in LDL-C III particle concentration was significantly greater with OM-3 FA plus atorvastatin compared with placebo plus atorvastatin (-67.5% vs -0%, respectively; P <0.001). OM-3 FA plus atorvastatin was associated with significant reductions in non-HDL-C (-9.5% vs 4.7%, P<0.01), TAG (-21.5% vs 6.2%, P <0.001) and VLDL-C (-36.9% vs 4.0%, P<0.001) and TC (-6.6% vs 2.1%, P<0.001). Between the groups, no significant difference in percent change in LDL-C, HDL-C, as well as LDL-C I and LDL-C II particle concentration was observed. Conclusion: In these adult, white patients with hyperlipidemia, P-OM3 plus atorvastatin improved LDL-C phenotype, non-HDL-C and other lipid and lipoprotein parameters to a greater extent than atorvastatin alone.