Endocrine Research Unit, Division of Endocrinology, Nutrition and Metabolism, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
J Clin Lipidol. 2007 Jul;1(3):211-7. doi: 10.1016/j.jacl.2007.05.002. Epub 2007 May 18.
Niacin and ω-3 fatty acids (ω-3 FA) are both nutrients that reduce serum triglyceride and raise high-density lipoprotein cholesterol (HDL-C) levels when used at pharmacological doses. The possibility that these two agents, given in combination, might have additive effects on these lipid parameters has not been examined previously. In addition, the combination might prevent the rise in low-density lipoprotein (LDL)-C levels frequently seen with ω-3 FA treatment.
To determine the effect of therapy of niacin and ω-3 FA alone and in combination versus placebo on lipid parameters in subjects with atherogenic dyslipidemia.
In a pilot parallel group study, we studied 29 patients with atherogenic dyslipidemia who were assigned to either dual placebo (n = 7), ω-3 FA (3.4 g/d; n = 8), crystalline niacin (3 g/d; n = 7), or the combination (n = 7) for 12 weeks. Fasting lipid profiles were assessed before and after treatment.
Changes in serum triglyceride levels from baseline were 10%, -2%, -17%, and -52%, respectively, while HDL-C concentrations rose by 4%, 10%, 18%, and 33%, respectively. Both of these results were statistically significantly different for combination therapy compared to changes with placebo and ω-3 FA monotherapy (analysis of variance with Tukey's post-hoc test). No statistically significant changes were seen for LDL-C. Addition of ω-FA to niacin had no effect on niacin-induced flushing.
From this small pilot study, we conclude that combined therapy with niacin and ω-3 FA has beneficial effects on triglyceride and HDL-C levels, and use of these two agents in combination prevents the ω-3 FA-induced rise in LDL-C. Larger studies of this combination therapy are clearly warranted in patient populations with atherogenic dyslipidemia to assess not only lipid effects, but also potential coronary heart disease benefits.
烟酸和 ω-3 脂肪酸（ω-3 FA）都是营养物质，当以药理剂量使用时，可降低血清甘油三酯并提高高密度脂蛋白胆固醇（HDL-C）水平。这两种药物联合使用是否可能对这些脂质参数产生相加作用尚未得到检验。此外，这种联合治疗可能会阻止 ω-3 FA 治疗中经常出现的低密度脂蛋白（LDL）-C 水平升高。
确定烟酸和 ω-3 FA 单独和联合治疗与安慰剂相比对动脉粥样硬化性血脂异常患者脂质参数的影响。
在一项先导性平行组研究中，我们研究了 29 例动脉粥样硬化性血脂异常患者，将其分为双重安慰剂（n = 7）、ω-3 FA（3.4 g/d；n = 8）、结晶烟酸（3 g/d；n = 7）或联合治疗（n = 7）组，治疗 12 周。在治疗前后评估空腹血脂谱。
与安慰剂和 ω-3 FA 单药治疗相比，血清甘油三酯水平从基线的变化分别为 10%、-2%、-17%和-52%，而 HDL-C 浓度分别升高 4%、10%、18%和 33%。这些结果在统计学上均与联合治疗组相比差异有统计学意义（方差分析和 Tukey 事后检验）。LDL-C 无统计学显著变化。ω-FA 与烟酸联合使用对烟酸引起的潮红无影响。
从这项小型先导研究中，我们得出结论，烟酸和 ω-3 FA 的联合治疗对甘油三酯和 HDL-C 水平有有益的影响，并且联合使用这两种药物可防止 ω-3 FA 引起的 LDL-C 升高。在动脉粥样硬化性血脂异常患者人群中，对这种联合治疗进行更大规模的研究显然是必要的，不仅要评估脂质作用，还要评估潜在的冠心病获益。
