Comparing the Impact of Prescription Omega-3 Fatty Acid Products on Low-Density Lipoprotein Cholesterol

Background: The one of the most common metabolic disorder that remains worldwide is Diabetes mellitus. Dietary intake of omega-3 fatty acid may confer a protective effect against diabetes, improves high density lipoprotein (HDL-C) and reduce low density lipoprotein cholesterol (LDL-C) levels. Objective: To observe the effect of supplementation of omega-3 fatty acid on HDL and LDL levels in type 2 DM. Methods: A prospective interventional study was conducted from January 2017 to December 2017. A total numbers of 52 diagnosed type 2 diabetic patients of both sexes were selected with age ranging from 40 to 50 years. Among them, 27 type 2 diabetic patients with supplementation of omega 3 fatty acid (2g/day) for 12 weeks was considered as study group. Another 25 type 2 diabetic patients without supplementation of omega 3 fatty acid were considered as control group for comparison. The study subjects were selected from Outpatient Department of Endocrinology, Dhaka Medical College Hospital, Dhaka and personal contact from Dhaka city on the basis of inclusion and exclusion criteria. The research work was carried out after obtaining ethical clearance from concerned departments, Research Review Committee and Ethical Review Committee of Dhaka medical college, Dhaka. The study parameters serum HDL was estimated by enzymatic colorimetric method in auto-analyzer and serum low density lipoprotein was calculated by using Friedwald formula in Department of Laboratory Medicine, Dhaka Medical College Hospital, Dhaka. The parameters were studied 2 times in study and control groups i.e. at the beginning of study (base line) and after 12 weeks of study period. Data were collected in pre-designed structured questionnaire from the researcher by herself. For statistical analysis, Paired Student’s ‘t’ test and Unpaired Student’s ‘t’ test were performed as applicable using SPSS for windows version 16.0. Results: In this study High density lipoprotein cholesterol that is good cholesterol increased and low density lipoprotein cholesterol was decreased in diabetic patients after supplementation with omega-3 fatty acid in comparison to that of their baseline value. Again, after 12 weeks, high density lipoprotein was higher and low density lipoprotein cholesterol was lower in diabetic patients after supplementation with omega-3 fatty acid in comparison to control group. Conclusion: After analyzing the results of the study, it can be concluded that omega-3 fatty acid can improve HDL and lowers LDL levels in diabetic patients may be helpful to minimize the complications of type-2 diabetes mellitus. J Dhaka Medical College, Vol. 27, No.2, October, 2018, Page 190-194

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Abstract 14430: Effect Modification of Statin Therapy on the Relationship of Low-density Lipoprotein Cholesterol With Incident CKD in Us Veterans

Circulation ◽

10.1161/circ.142.suppl_3.14430 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Jui-Ting Hsiung ◽

Maria Marroquin ◽

Kamyar Kalantar-Zadeh

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Low Density ◽

Low Density Lipoprotein Cholesterol ◽

Us Veterans ◽

The Impact ◽

Statin Use

Background: Studies suggests that in the general population, hyperlipidemia may confer higher risk of developing chronic kidney disease (CKD). But, there is conflicting data as to whether statins can protect renal function or slow renal degradation. We sought to examine the impact of statins on the association of low-density lipoprotein cholesterol (LDL) and risk of incident CKD. Methods: Our cohort included 1,439,756 US veterans without chronic kidney disease (CKD), but with LDL measured between 2004-2006, who were followed until 2014. Incident CKD was defined as over 3 estimated glomerular filtration rate (eGFR) measurements <60 mL/min/1.73m 2 at least 90 days apart. Patients with a statin prescription at the time of LDL measurement were identified. Cox models were used to estimate the associations between LDL with incident CKD. Model adjustments include demographics, comorbidities, smoking status, prescription of fibrate or niacin, body mass index, albumin, high-density lipoprotein cholesterol, and triglycerides. Results: The cohort included 5% females, 16% African Americans, 26% diabetics, and 30% statin-users, with a mean age of 60±13 years. The median [IQR] of LDL and eGFR were 109 [88,133] mg/dL and 83 [72,94] mL/min/1.73m 2 , respectively. A J-shaped association between LDL and incident CKD were observed in both those on statin and not on a statin after adjustment. Low LDL (<70 mg/dL) was associated with a higher risk of incident CKD compared to the reference (LDL 70-<100 mg/dL) regardless of statin use. High LDL ≥160 mg/dL was associated with the highest of risks of incident CKD (HR: 1.08, 95% CI: 1.04, 1.13, and HR: 1.10, 95% CI: 1.07, 1.12, for statin use and no statin use, respectively). Conclusion: Both high and low LDL were associated with higher incident CKD risk independent of statin use in this US veteran cohort. Further studies are needed to understand how to manage cardiovascular disease risk by lowering LDL while simultaneously reducing risk of CKD.

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Total and low-density-lipoprotein cholesterol lipoprotein fractions and fecal fatty acid excretion of men consuming diets containing high concentrations of stearic acid

American Journal of Clinical Nutrition ◽

10.1093/ajcn/60.6.1043s ◽

1994 ◽

Vol 60 (6) ◽

pp. 1043S-1043S ◽

Cited By ~ 1

Author(s):

R M Dougherty ◽

M A Allman ◽

J M Iacono

Keyword(s):

Fatty Acid ◽

Stearic Acid ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Low Density ◽

Acid Excretion ◽

Low Density Lipoprotein Cholesterol ◽

High Concentrations

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Omega-3 Fatty Acids for the Management of Hypertriglyceridemia: A Science Advisory From the American Heart Association

Circulation ◽

10.1161/cir.0000000000000709 ◽

2019 ◽

Vol 140 (12) ◽

Cited By ~ 65

Author(s):

Ann C. Skulas-Ray ◽

Peter W.F. Wilson ◽

William S. Harris ◽

Eliot A. Brinton ◽

Penny M. Kris-Etherton ◽

...

Keyword(s):

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Heart Association ◽

The United States ◽

Lipoprotein Cholesterol ◽

Low Density ◽

Omega 3 Fatty Acids ◽

Omega 3 ◽

Low Density Lipoprotein Cholesterol ◽

Very High

Hypertriglyceridemia (triglycerides 200–499 mg/dL) is relatively common in the United States, whereas more severe triglyceride elevations (very high triglycerides, ≥500 mg/dL) are far less frequently observed. Both are becoming increasingly prevalent in the United States and elsewhere, likely driven in large part by growing rates of obesity and diabetes mellitus. In a 2002 American Heart Association scientific statement, the omega-3 fatty acids (n-3 FAs) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were recommended (at a dose of 2–4 g/d) for reducing triglycerides in patients with elevated triglycerides. Since 2002, prescription agents containing EPA+DHA or EPA alone have been approved by the US Food and Drug Administration for treating very high triglycerides; these agents are also widely used for hypertriglyceridemia. The purpose of this advisory is to summarize the lipid and lipoprotein effects resulting from pharmacological doses of n-3 FAs (>3 g/d total EPA+DHA) on the basis of new scientific data and availability of n-3 FA agents. In treatment of very high triglycerides with 4 g/d, EPA+DHA agents reduce triglycerides by ≥30% with concurrent increases in low-density lipoprotein cholesterol, whereas EPA-only did not raise low-density lipoprotein cholesterol in very high triglycerides. When used to treat hypertriglyceridemia, n-3 FAs with EPA+DHA or with EPA-only appear roughly comparable for triglyceride lowering and do not increase low-density lipoprotein cholesterol when used as monotherapy or in combination with a statin. In the largest trials of 4 g/d prescription n-3 FA, non–high-density lipoprotein cholesterol and apolipoprotein B were modestly decreased, indicating reductions in total atherogenic lipoproteins. The use of n-3 FA (4 g/d) for improving atherosclerotic cardiovascular disease risk in patients with hypertriglyceridemia is supported by a 25% reduction in major adverse cardiovascular events in REDUCE-IT (Reduction of Cardiovascular Events With EPA Intervention Trial), a randomized placebo-controlled trial of EPA-only in high-risk patients treated with a statin. The results of a trial of 4 g/d prescription EPA+DHA in hypertriglyceridemia are anticipated in 2020. We conclude that prescription n-3 FAs (EPA+DHA or EPA-only) at a dose of 4 g/d (>3 g/d total EPA+DHA) are an effective and safe option for reducing triglycerides as monotherapy or as an adjunct to other lipid-lowering agents.

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Low‐Density Lipoprotein Cholesterol Corrected for Lipoprotein(a) Cholesterol, Risk Thresholds, and Cardiovascular Events

Journal of the American Heart Association ◽

10.1161/jaha.119.016318 ◽

2020 ◽

Vol 9 (23) ◽

Author(s):

Peter Willeit ◽

Calvin Yeang ◽

Patrick M. Moriarty ◽

Lena Tschiderer ◽

Stephen A. Varvel ◽

...

Keyword(s):

Cardiovascular Disease ◽

Clinical Care ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Cholesterol Content ◽

Lipoprotein Cholesterol ◽

Low Density ◽

Low Density Lipoprotein Cholesterol ◽

Lipoprotein A ◽

The Impact

Background Conventional "low‐density lipoprotein cholesterol (LDL‐C)" assays measure cholesterol content in both low‐density lipoprotein and lipoprotein(a) particles. To clarify the consequences of this methodological limitation for clinical care, our study aimed to compare associations of “LDL‐C” and corrected LDL‐C with risk of cardiovascular disease and to assess the impact of this correction on the classification of patients into guideline‐recommended LDL‐C categories. Methods and Results Lipoprotein(a) cholesterol content was estimated as 30% of lipoprotein(a) mass and subtracted from “LDL‐C” to obtain corrected LDL‐C values (LDL‐C corr30 ). Hazard ratios for cardiovascular disease (defined as coronary heart disease, stroke, or coronary revascularization) were quantified by individual‐patient‐data meta‐analysis of 5 statin landmark trials from the Lipoprotein(a) Studies Collaboration (18 043 patients; 5390 events; 4.7 years median follow‐up). When comparing top versus bottom quartiles, the multivariable‐adjusted hazard ratio for cardiovascular disease was significant for “LDL‐C” (1.17; 95% CI, 1.05–1.31; P =0.005) but not for LDL‐C corr30 (1.07; 95% CI, 0.93–1.22; P =0.362). In a routine laboratory database involving 531 144 patients, reclassification of patients across guideline‐recommended LDL‐C categories when using LDL‐C corr30 was assessed. In “LDL‐C” categories of 70 to <100, 100 to <130, 130 to <190, and ≥190 mg/dL, significant proportions (95% CI) of participants were reassigned to lower LDL‐C categories when LDL‐C corr30 was used: 30.2% (30.0%–30.4%), 35.1% (34.9%–35.4%), 32.9% (32.6%–33.1%), and 41.1% (40.0%–42.2%), respectively. Conclusions “ LDL‐C” was associated with incident cardiovascular disease only when lipoprotein(a) cholesterol content was included in its measurement. Refinement in techniques to accurately measure LDL‐C, particularly in patients with elevated lipoprotein(a) levels, is warranted to assign risk to the responsible lipoproteins.

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