0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Can the Hypotriglyceridemic Effect of Fish Oil Concentrate Be Sustained?

Gordon Schectman, MD; Sushma Kaul, MS; George D. Cherayil, PhD; Martha Lee, PhD; and Ahmed Kissebah, MD, PhD
[+] Article and Author Information

Grant Support: Supported by Grant 77-33-03R from the Veterans Administration and by General Clinical Research Center grant RR00058.

Requests for Reprints: Gordon Schectman, MD, Division of General Internal Medicine, Medical College of Wisconsin, 8700 West Wisconsin Avenue, Milwaukee, WI 53226.

Current Author Addresses: Dr. Schectman: Division of General Internal Medicine, Medical College of Wisconsin, 8700 West Wisconsin Avenue, Milwaukee, WI 53226.

Drs. Kaul and Lee: Clinical Research Center, 9200 West Wisconsin Avenue, Milwaukee, WI 52336.

Dr. Cherayil: Department of Pathology, Medical College of Wisconsin, 8700 West Wisconsin Avenue, Milwaukee, WI 53226.

Dr. Kissebah: Department of Medicine, Medical College of Wisconsin, 8700 West Wisconsin Avenue, Milwaukee, WI 53226.


© 1989 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1989;110(5):346-352. doi:10.7326/0003-4819-110-5-346
Text Size: A A A

Study Objective: To determine whether high doses of fish oil concentrate followed by low-dose maintenance therapy can sustain the initial plasma triglyceride reductions.

Design: Before-and-after trial with 3-month treatment periods.

Setting: Outpatient lipid clinic at a university medical center.

Patients: Sixteen patients with hypertriglyceridemia recruited from the General Internal Medicine Clinics. Five had concomitant hypercholesterolemia (type IIb).

Intervention: Fish oil supplementation at two doses. After basal measurements, 9.8 g/d omega-3 fatty acids were provided for study months 1 to 3, and 3.9 g/d were provided for study months 4 to 6.

Measurements and Main Results: Blood was drawn monthly and plasma was analyzed for levels of triglycerides, low-density-lipoprotein (LDL) cholesterol and apolipoprotein B, high-density-lipoprotein (HDL) cholesterol and apolipoprotein A1, and glucose and glycohemoglobin. During therapy with the higher dose, mean plasma triglyceride levels were reduced from 3.65 ± 0.35 mmol/L at baseline to 1.85 ± 0.20 mmol/L at 1 month, but increased by 30% to 2.40 ± 0.30 mmol/L by the third month of therapy (P < 0.05); this increase could not be explained by changes in body weight or compliance. Plasma triglyceride levels continued to increase with low-dose therapy and remained only 11 % below baseline values by the sixth month of therapy (P = not significant). Although fish oil therapy increased HDL cholesterol levels ( + 18% at high dose; 99% CI, 5% to 31%), favorable changes were not seen in LDL cholesterol, apolipoprotein B, or apolipoprotein A1 levels.

Conclusions: Fish oil concentrate at high doses followed by low-dose maintenance therapy cannot sustain the initial large plasma triglyceride reductions. Moreover, the efficacy of the higher dose becomes less pronounced after the first month of therapy. This reduced efficacy during prolonged therapy, and the lack of beneficial effect on apolipoprotein and LDL cholesterol levels, may limit the practical benefit of fish oil in the treatment of hypertriglyceridemia.

Topics

fish oil

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Journal Club
Topic Collections
PubMed Articles

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)