An omega-3 polyunsaturated fatty acid concentrate increases plasma high-density lipoprotein 2 cholesterol and paraoxonase levels in patients with familial combined hyperlipidemia

Metabolism. 2004 Feb;53(2):153-8. doi: 10.1016/j.metabol.2003.09.007.


A remarkable reduction of plasma concentrations of high-density lipoproteins (HDL), especially of the HDL(2) subfraction, is one of the typical lipoprotein alterations found in patients with familial combined hyperlipidemia (FCHL). Fourteen FCHL patients received 4 capsules daily of Omacor (an omega-3 polyunsaturated fatty acid [omega3 FA] concentrate providing 1.88 g of eicosapentaenoic acid [EPA] and 1.48 g of docosahexaenoic acid [DHA] per day; Pronova Biocare, Oslo, Norway) or placebo for 8 weeks in a randomized, double-blind, crossover study. Plasma triglycerides were 44% lower, and LDL cholesterol and apoliporpotein (apo)B were 25% and 7% higher after Omacor than placebo. HDL cholesterol was higher (+8%) after Omacor than placebo, but this difference did not achieve statistical significance. Omacor caused a selective increase of the more buoyant HDL(2) subfraction; plasma HDL(2) cholesterol and total mass increased by 40% and 26%, respectively, whereas HDL(3) cholesterol and total mass decreased by 4% and 6%. Both HDL(2) and HDL(3) were enriched in cholesteryl esters and depleted of triglycerides after Omacor. No changes were observed in the plasma concentration of major HDL apolipoproteins, LpA-I and LpA-I:A-II particles, lecithin:cholesterol acyltransferase (LCAT), and cholesteryl ester transfer protein (CETP). The plasma concentration of the HDL-bound antioxidant enzyme paraoxonase increased by 10% after Omacor. Omacor may be helpful in correcting multiple lipoprotein abnormalities and reducing cardiovascular risk in FCHL patients.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Apolipoproteins A / blood
  • Aryldialkylphosphatase / blood*
  • Carrier Proteins / blood
  • Cholesterol Ester Transfer Proteins
  • Cholesterol, HDL / blood*
  • Cholesterol, LDL / blood
  • Cross-Over Studies
  • Docosahexaenoic Acids / pharmacology
  • Double-Blind Method
  • Electrophoresis, Polyacrylamide Gel
  • Fatty Acids, Omega-3 / therapeutic use*
  • Female
  • Glycoproteins*
  • Humans
  • Hyperlipidemias / blood*
  • Hyperlipidemias / drug therapy
  • Hyperlipidemias / genetics*
  • Male
  • Particle Size
  • Phosphatidylcholine-Sterol O-Acyltransferase / blood
  • Triglycerides / blood
  • Ultracentrifugation


  • Apolipoproteins A
  • CETP protein, human
  • Carrier Proteins
  • Cholesterol Ester Transfer Proteins
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Fatty Acids, Omega-3
  • Glycoproteins
  • Triglycerides
  • Docosahexaenoic Acids
  • Phosphatidylcholine-Sterol O-Acyltransferase
  • Aryldialkylphosphatase