Hypertriglyceridemia omega-3 fatty acids

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]

Overview

Treatment of hypertriglyceridemia is by restriction of carbohydrates and fat in the diet, as well as with niacin, fibrates and statins (three classes of drugs). Increased fish oil intake may substantially lower an individual's triglycerides..

Omega-3 fatty acids

Mechanism of benefit

• Decreased hepatic lipogenesis
• Increased plasma lipoprotein lipase activity.
• Increased hepatic mitochondrial and peroxisomal beta-oxidation
• Inhibition of acyl CoA:1,2-diacylglycerol acyltransferase enzyme
• Omega-3 fatty acids component EPA and DHA are poor enzyme substrates for triglyceride synthesis in the liver
• EPA and DHA inhibits esterification of other fatty acids.

Side-effects

• Dose dependent gastrointestinal side-effects like nausea (approximately 4 % of individuals at < 3 gm/d, and 20% at >4gm/d.
• The peculiar fishy smell can be a reason for discontinuation among many patients. This can be reduced by
  • Freezing of medication
  • Trying different medication prepration
  • Taking drugs with food
• Increased incidences of bleeding at high doses (According to FDA total intakes up to 3 g per day of EPA and DHA comes under the category of Generally Recognized As Safe (GRAS)

References

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