Effect of N-3 Polyunsaturated Fatty Acids on Lipid Composition in Familial Hypercholesterolemia : A Randomized Crossover Trial

• Published in: Biomedicines
• Main Authors: Hande, Liv Nesse, Kjellmo, Christian, Pettersen, Kristin, Ljunggren, Stefan, Karlsson, Helen, Cederbrant, Karin, Marcusson-Ståhl, Maritha, Hovland, Anders, Lappegard, Knut Tore
• Format: Article in Journal/Newspaper
• Language: English
• Published: Linköpings universitet, Avdelningen för prevention, rehabilitering och nära vård 2022
• Subjects: familial hypercholesterolemia; omega-3 fatty acids; lipids; cardiovascular disease; randomized trial; Endocrinology and Diabetes; Endokrinologi och diabetes; Arctic; Norway; Northern Norway; Arctic University of Norway; UiT The Arctic University of Norway
• Online Access: http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-188452; https://doi.org/10.3390/biomedicines10081809

Individuals with familial hypercholesterolemia (FH) have an increased risk of cardiovascular disease. Treatment is mainly low-density lipoprotein cholesterol (LDL-C) reduction. How omega-3 polyunsaturated fatty acids (n-3 PUFAs) supplements affect lipoproteins in FH subjects is unknown. We hypothesized that a high-dose n-3 PUFA supplement would reduce atherogenic lipoproteins and influence the high-density lipoprotein cholesterol (HDL-C) function. We performed a randomized, double-blinded crossover study with 34 genetically verified FH individuals (18-75 years, clinically stable, statin treatment > 12 months). Treatment was 4 g n-3 PUFAs (1840 mg eicosapentaenoic acid and 1520 mg docosahexaenoic acid daily) or four capsules of olive oil for three months in a crossover design with a washout period of three months. The defined outcomes were changes in triglycerides, lipoproteins, lipoprotein subfractions, apolipoproteins, and HDL-C function. After treatment with n-3 PUFAs, total cholesterol, LDL-C, and triglycerides were reduced compared to placebo (p <= 0.01 for all). Total HDL-C levels were unchanged, but the subfraction of large HDL-C was higher (p <= 0.0001) after n-3 PUFAs than after placebo, and intermediate HDL-C and small HDL-C were reduced after n-3 PUFAs compared to placebo (p = 0.02 and p <= 0.001, respectively). No changes were found in apolipoproteins and HDL-C function. N-3 PUFAs supplements reduced atherogenic lipoproteins in FH subjects, leaving HDL-C function unaffected. Funding Agencies|Northern Norway Regional Health Authority (Helse Nord RHF) [SFP1311-16]; UiT The Arctic University of Norway