Significant differential effects of omega-3 fatty acids and fenofibrate in patients with hypertriglyceridemia

Atherosclerosis. 2012 Feb;220(2):537-44. doi: 10.1016/j.atherosclerosis.2011.11.018. Epub 2011 Nov 19.

Abstract

Background: Omega-3 fatty acids and fenofibrate are both used to treat patients with hypertriglyceridemia. However, a head-to-head comparison of the lipoprotein and metabolic effects of these two medicines has not been published.

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. Fifty patients in each group were given placebo, omega-3 fatty acids 2 g (most commonly used dosage in Korean patients), or fenofibrate 160 mg, respectively daily for 2 months.

Results: 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).

Conclusions: 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.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiponectin / blood
  • Analysis of Variance
  • Apolipoprotein A-I / blood
  • Biomarkers / blood
  • Blood Glucose / metabolism
  • C-Reactive Protein / metabolism
  • Cholesterol, HDL / blood
  • Dietary Supplements*
  • Fatty Acids, Omega-3 / therapeutic use*
  • Female
  • Fenofibrate / therapeutic use*
  • Fibrinogen / metabolism
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Hypertriglyceridemia / blood
  • Hypertriglyceridemia / drug therapy*
  • Hypertriglyceridemia / physiopathology
  • Hypolipidemic Agents / therapeutic use*
  • Inflammation Mediators / blood
  • Insulin / blood
  • Insulin Resistance
  • Male
  • Middle Aged
  • Republic of Korea
  • Single-Blind Method
  • Time Factors
  • Treatment Outcome
  • Triglycerides / blood
  • Vasodilation / drug effects

Substances

  • ADIPOQ protein, human
  • APOA1 protein, human
  • Adiponectin
  • Apolipoprotein A-I
  • Biomarkers
  • Blood Glucose
  • Cholesterol, HDL
  • Fatty Acids, Omega-3
  • Glycated Hemoglobin A
  • Hypolipidemic Agents
  • Inflammation Mediators
  • Insulin
  • Triglycerides
  • hemoglobin A1c protein, human
  • Fibrinogen
  • C-Reactive Protein
  • Fenofibrate