n-3 PUFA Esterified to Glycerol or as Ethyl Esters Reduce Non-Fasting Plasma Triacylglycerol in Subjects with Hypertriglyceridemia: A Randomized Trial

• Published in: Lipids Vol. 50; no. 2; pp. 165 - 175
• Main Authors: Hedengran, Anne, Szecsi, Pal B., Dyerberg, Jørn, Harris, William S., Stender, Steen
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2015; Springer Nature B.V
• Subjects: Aged; Biomedical and Life Sciences; Cardiovascular diseases; Cholesterol; Docosahexaenoic acids; Double-Blind Method; Eicosapentaenoic acid; erythrocytes; esterification; Esters; Esters - chemistry; Esters - therapeutic use; fasting; Fasting - blood; Fatty Acids, Omega-3 - chemistry; Fatty Acids, Omega-3 - therapeutic use; Female; Glycerides - chemistry; Glycerides - therapeutic use; glycerol; Health risks; Heart rate; high density lipoprotein; Humans; hypertriglyceridemia; Hypertriglyceridemia - blood; Hypertriglyceridemia - diet therapy; Life Sciences; Lipidology; Lipoprotein‐associated phospholipase A2; Male; Medical Biochemistry; Medicinal Chemistry; Microbial Genetics and Genomics; Middle Aged; Neurochemistry; Non‐fasting; Nutrition; n‐3 Polyunsaturated fatty acid; omega-3 fatty acids; Omega‐3 acylglycerol; Omega‐3 ethyl ester; Original Article; phospholipase A2; Polyunsaturated fatty acids; risk; Triacylglycerols; Triglycerides - blood; Omega-3 acylglycerol; Heart rate; n-3 Polyunsaturated fatty acid; Lipoprotein-associated phospholipase A2; Omega-3 ethyl ester; Docosahexaenoic acids; Non-fasting; Eicosapentaenoic acid; Triacylglycerols
• ISSN: 0024-4201; 1558-9307; 1558-9307
• DOI: 10.1007/s11745-014-3968-6

To date, treatment of hypertriglyceridemia with long-chain n-3 polyunsaturated fatty acids (n-3 PUFA) has been investigated solely in fasting and postprandial subjects. However, non-fasting triacylglycerols are more strongly associated with risk of cardiovascular disease. The objective of this study was to investigate the effect of long-chain n-3 PUFA on non-fasting triacylglycerol levels and to compare the effects of n-3 PUFA formulated as acylglycerol (AG-PUFA) or ethyl esters (EE-PUFA). The study was a double-blinded randomized placebo-controlled interventional trial, and included 120 subjects with non-fasting plasma triacylglycerol levels of 1.7–5.65 mmol/L (150–500 mg/dL). The participants received approximately 3 g/day of AG-PUFA, EE-PUFA, or placebo for a period of eight weeks. The levels of non-fasting plasma triacylglycerols decreased 28 % in the AG-PUFA group and 22 % in the EE-PUFA group ( P  < 0.001 vs. placebo), with no significant difference between the two groups. The triacylglycerol lowering effect was evident after four weeks, and was inversely correlated with the omega-3 index (EPA + DHA content in erythrocyte membranes). The omega-3 index increased 63.2 % in the AG-PUFA group and 58.5 % in the EE-PUFA group ( P  < 0.001). Overall, the heart rate in the AG-PUFA group decreased by three beats per minute ( P  = 0.045). High-density lipoprotein (HDL) cholesterol increased in the AG-PUFA group ( P  < 0.001). Neither total nor non-HDL cholesterol changed in any group. Lipoprotein-associated phospholipase A2 (LpPLA2) decreased in the EE-PUFA group ( P  = 0.001). No serious adverse events were observed. Supplementation with long-chain n-3 PUFA lowered non-fasting triacylglycerol levels, suggestive of a reduction in cardiovascular risk. Regardless of the different effects on heart rate, HDL, and LpPLA2 that were observed, compared to placebo, AG-PUFA, and EE-PUFA are equally effective in reducing non-fasting triacylglycerol levels.