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.[1][2][3].
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 acid's component eicosapentaenoic acid (EPA), and docosahexaenoic acid (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 experiences gastrointestinal side-effects)[4]
- The peculiar fishy smell can be a reason for discontinuation among many patients. This can be reduced by
- Freezing of medication
- Trying different medication preparation
- Taking medication with food
- Increased incidences of bleeding at high doses (According to FDA total intake up to 3 g per day of eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) comes under the category of "Generally Recognized As Safe" (GRAS). Large randomized trials are required to establish the association between omega-3 fatty acids and bleeding [4].
External links
http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=184
References
- ↑ "Lipids Online Slides: hypertriglyceridemia, ICAM-1, fish oil, E-selectin".
- ↑ Terres W, Beil U, Reimann B, Tiede S, Bleifeld W (1991). "[Low-dose fish oil in primary hypertriglyceridemia. A randomized placebo-controlled study]". Zeitschrift für Kardiologie (in German). 80 (1): 20–4. PMID 2035283.
- ↑ "Fish oils in hypertriglyceridemia - Fish Oils Revisited Nutrition Research Newsletter - Find Articles".
- ↑ 4.0 4.1 Wang C, Harris WS, Chung M, Lichtenstein AH, Balk EM, Kupelnick B; et al. (2006). "n-3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review". Am J Clin Nutr. 84 (1): 5–17. PMID 16825676.