Effect of omega-3 fatty acid ethyl esters on postprandial arterial elasticity in patients with familial hypercholesterolemia.
Abstract
BACKGROUND
Impaired arterial elasticity reflects increased risk of atherosclerotic cardiovascular disease in patients with familial hypercholesterolemia (FH). Treatment with omega-3 fatty acid ethyl esters (omega-3FAEEs) in FH patients has been shown to improve postprandial triglyceride-rich lipoprotein (TRL) metabolism, including TRL- apolipoprotein(a) [TRL-apo(a)]. Whether omega-3FAEE intervention also improves postprandial arterial elasticity in FH has not been demonstrated.
METHODS
We carried out an 8-week open-label, randomized, crossover trial to test the effect of omega-3FAEEs (4 g/day) on postprandial arterial elasticity in 20 FH subjects following ingestion of an oral fat load. Fasting and postprandial large (C1) and small (C2) artery elasticity at 4 and 6 h were measured by pulse contour analysis of the radial artery. The area under-the-curves (AUCs) (0-6 h) for C1, C2, plasma triglycerides and TRL-apo(a) were determined using the trapezium rule.
RESULTS
Compared with no treatment, omega-3FAEEs significantly increased fasting (+9%, P < 0.05) and postprandial C1 at 4 h (+13%, P < 0.05) and at 6 h (+10%, P < 0.05), with improvement in the postprandial C1 AUC (+10%, P < 0.01). omega-3FAEEs also decreased postprandial triglyceride and TRL-apo(a) AUCs (-17% and -19%, respectively, P < 0.05). omega-3FAEEs had no significant effect on fasting and postprandial C2. The change in C1 AUC was inversely associated with the changes in the AUC of triglycerides (r = -0.609, P < 0.01) and TRL-apo(a) (r = -0.490, P < 0.05).
CONCLUSIONS
High-dose omega-3FAEEs improves postprandial large artery elasticity in adults with FH. Reduction in postprandial TRL-apo(a) with omega-3FAEEs may contribute to the improvement in large artery elasticity. However, our findings need to be confirmed in a larger population.
CLINICAL TRIAL REGISTRATION
https://www.
CLINICALTRIALS
com/NCT01577056.