Significant differential effects of omega-3 fatty acids and fenofibrate in patients with hypertriglyceridemia
Atherosclerosis, 01/30/2012
Koh KK et al. – Omega–3 fatty acids and fenofibrate therapy promoted similar changes in triglycerides and endothelium–dependent dilation. However, fenofibrate therapy had substantially better effects on lipoprotein and metabolic profiles in patients with hypertriglyceridemia.
Methods- This was a randomized, single–blind, placebo–controlled, parallel study.
- Age, sex, and body mass index were matched among groups.
- All patients were recommended to maintain a low fat diet.
- 50 patients in each group were given placebo, omega–3 fatty acids 2g (most commonly used dosage in Korean patients), or fenofibrate 160mg, respectively daily for 2 months.
- Omega–3 fatty acids therapy decreased triglycerides by 21% and triglycerides/HDL cholesterol and improved flow–mediated dilation (P<0.01), however, did not significantly change insulin, plasma adiponectin levels, and insulin sensitivity (determined by QUICKI) relative to baseline measurements.
- Fenofibrate therapy decreased total cholesterol, triglycerides by 29%, and triglycerides/HDL–cholesterol (all P<0.01) and improved flow–mediated dilation when compared with baseline.
- When compared with placebo and omega–3 fatty acids, fenofibrate therapy decreased non–HDL cholesterol (P<0.001) and triglycerides/HDL cholesterol (P=0.016) while increasing HDL cholesterol (P<0.001) and apolipoprotein AI (P=0.001).
- Of note, when compared with omega–3 fatty acids, fenofibrate therapy decreased fasting insulin (P=0.023) and increased plasma adiponectin (P=0.002) and insulin sensitivity (P=0.015).
