Patel Jeetesh V, Lee Kaeng W, Tomson Joseph, Dubb Kiran, Hughes Elizabeth A, Lip Gregory Y H
Haemostasis Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham B18 7QH, UK.
Int J Cardiol. 2007 Jan 31;115(1):42-5. doi: 10.1016/j.ijcard.2006.04.004. Epub 2006 Jun 15.
Long-chain omega-3 polyunsaturated fatty acids (PUFA) supplementation is used as a therapeutic secondary prevention strategy among post-myocardial infarction (MI) patients. The effects of omega-3 PUFA on markers of energy homeostasis among post-MI patients are unclear.
We investigated the effects of Omacor (a pharmaceutical capsule formulation of highly refined, concentrated omega-3 PUFA; Solvay Healthcare, Southampton, UK; 1 g/day) in addition to usual care (cardiovascular therapy) in a pilot randomised study of 35 post-MI men. Following randomisation to Omacor (n=16), or 'usual care' controls (n=19), fasting levels of insulin, non-esterified fatty acids (NEFA), triglycerides, glucose and adipocytokines (adiponectin, leptin and tumour necrosis factor (TNF)-alpha), as indices of markers of energy homeostasis, were measured at baseline and after 3-month treatment.
There were no baseline differences in age, body mass index, blood pressure, fasting triglycerides, plasma glucose, NEFA and adipocytokines between the two treatment arms (P=0.07). There were no significant changes in metabolically active hormones within groups after 3-month treatment. Across arms, the direction of baseline to follow-up changes in insulin levels were significantly different (P= 0.03), with a mean increase with Omacor (+3.39 mU/ml) and a decrease among controls (-17.6 mU/ml), without associated deteriorating changes in triglycerides, NEFA or plasma glucose.
This pilot study suggests that Omacor had little effect on glycaemic control among male post-MI patients. However, Omacor was associated with raised insulin levels, compared to usual care; thus, a metabolic basis for the cardioprotective action of Omacor, outside of its lipid lowering effects, merits further investigation.
补充长链ω-3多不饱和脂肪酸（PUFA）被用作心肌梗死（MI）后患者的一种治疗性二级预防策略。ω-3 PUFA对MI后患者能量稳态标志物的影响尚不清楚。
在一项针对35名MI后男性的试点随机研究中，我们除了给予常规治疗（心血管治疗）外，还研究了Omacor（一种高度精炼、浓缩的ω-3 PUFA的药物胶囊制剂；英国南安普敦索尔维医疗保健公司；每日1克）的效果。在随机分为Omacor组（n = 16）或“常规治疗”对照组（n = 19）后，在基线和3个月治疗后测量空腹胰岛素、非酯化脂肪酸（NEFA）、甘油三酯、葡萄糖和脂肪细胞因子（脂联素、瘦素和肿瘤坏死因子（TNF）-α）水平，作为能量稳态标志物的指标。
两个治疗组在年龄、体重指数、血压、空腹甘油三酯、血糖、NEFA和脂肪细胞因子方面基线无差异（P = = 0.07）。3个月治疗后，各组内代谢活性激素无显著变化。在两组之间，胰岛素水平从基线到随访的变化方向有显著差异（P = 0.03），Omacor组平均升高（+3.39 mU/ml），对照组降低（-17.6 mU/ml），甘油三酯、NEFA或血糖无相关恶化变化。
这项试点研究表明，Omacor对MI后男性患者的血糖控制几乎没有影响。然而，与常规治疗相比，Omacor与胰岛素水平升高有关；因此，Omacor除降脂作用外的心脏保护作用的代谢基础值得进一步研究。
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