Radiant Research, 515 North State Street, Suite 2700, Chicago, IL 60654, USA; The University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
J Clin Lipidol. 2009 Oct;3(5):332-40. doi: 10.1016/j.jacl.2009.08.001. Epub 2009 Aug 31.
Prescription omega-3-acid ethyl esters (P-OM3) often are used for hypertriglyceridemic patients receiving statin therapy who have residual increases in atherogenic lipoprotein lipid levels. To date, limited information has been published regarding the effects of omega-3 fatty acid consumption on lipoprotein particle concentrations.
We evaluated the effects of adding P-OM3 4g/d to an ongoing regimen of simvastatin 40mg/d on lipoprotein particles (P) in subjects with hypertriglyceridemia.
Data were analyzed from the multicenter, randomized, double-blind, placebo-controlled Combination of Prescription Omega-3s with Simvastatin (COMBOS) study. After an 8-week simvastatin lead-in, 254 subjects received P-OM3 (n=122) or placebo (n=132) for an additional 8 weeks. Nuclear magnetic resonance spectroscopy was used to assess lipoprotein concentrations and sizes. Remnant-like particle cholesterol, apolipoprotein (Apo) CIII, Apo AI, and lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) levels also were measured.
Compared with placebo, P-OM3 reduced mean very-low-density lipoprotein (VLDL-P) size and increased low-density lipoprotein particle (LDL-P) size (P < .006 for both) without altering high-density lipoprotein particle (HDL-P) size. P-OM3 did not significantly change total VLDL-P or LDL-P concentrations relative to placebo, but large VLDL-P and intermediate-density lipoprotein particle (IDL-P) concentrations were lowered (P < .01 for both), and the large LDL-P concentration was increased (P < .0001). HDL-P concentration was reduced (P < .0001) as the result of a decrease in medium HDL-P. Remnant-like particle cholesterol, Apo CIII, and Lp-PLA(2) concentrations were reduced compared with placebo (all P < .003).
P-OM3 induces changes in sizes, concentrations, and compositions of lipoproteins that may have relevance for the atherothrombotic process.
处方ω-3-酸乙酯（P-OM3）通常用于接受他汀类药物治疗但载脂蛋白脂质水平仍升高的高甘油三酯血症患者。迄今为止，关于ω-3 脂肪酸消耗对脂蛋白颗粒浓度的影响，发表的信息有限。
我们评估了在高甘油三酯血症患者中，每天添加 4g P-OM3 至持续的辛伐他汀 40mg/d 治疗方案对脂蛋白颗粒（P）的影响。
对多中心、随机、双盲、安慰剂对照的处方 ω-3 与辛伐他汀联合治疗（COMBOS）研究的数据进行了分析。在辛伐他汀导入 8 周后，254 名受试者接受 P-OM3（n=122）或安慰剂（n=132）治疗，为期 8 周。使用核磁共振光谱法评估脂蛋白浓度和大小。还测量了残粒样脂蛋白胆固醇、载脂蛋白（Apo）CIII、Apo AI 和脂蛋白相关磷脂酶 A2（Lp-PLA2）水平。
与安慰剂相比，P-OM3 降低了平均极低密度脂蛋白（VLDL-P）颗粒大小，并增加了低密度脂蛋白颗粒（LDL-P）大小（均 P<.006），而高密度脂蛋白颗粒（HDL-P）大小没有改变。与安慰剂相比，P-OM3 对总 VLDL-P 或 LDL-P 浓度没有显著变化，但大 VLDL-P 和中间密度脂蛋白颗粒（IDL-P）浓度降低（均 P<.01），大 LDL-P 浓度升高（P<.0001）。HDL-P 浓度降低（P<.0001）是由于中 HDL-P 减少所致。残粒样脂蛋白胆固醇、Apo CIII 和 Lp-PLA2 浓度与安慰剂相比降低（均 P<.003）。
P-OM3 诱导脂蛋白大小、浓度和组成的变化，这可能与动脉血栓形成过程有关。
