Sanford Research/USD, University of South Dakota, Sioux Falls, SD, USA.
J Lipid Res. 2012 Nov;53(11):2429-35. doi: 10.1194/jlr.P022392. Epub 2012 Aug 14.
The metabolic syndrome includes both dyslipidemia and impaired vascular function. Because extended-release niacin (ERN) and prescription omega-3 acid ethyl-esters (P-OM3) independently improve these characteristics, we tested their effects in combination. Sixty metabolic syndrome subjects were randomized to 16 weeks of treatment on dual placebo, P-OM3 (4 g/day), ERN (2 g/day), or combination in a double-blind trial. Lipoprotein subfractions and vascular endpoints were measured and tested using ANCOVA. ERN increased HDL cholesterol by 5.4 mg/dl from baseline (P = 0.04), decreased triglycerides (TG) by 39 mg/dl (-21%, P = 0.003), and decreased the augmentation index, which is a measure of vascular stiffness, by 3.5 units (P = 0.04). P-OM3 reduced TG by 26 mg/dl (-13%, P = 0.04). Combination treatment increased HDL cholesterol by 7.8 mg/dl (P = 002) and decreased TG by 72 mg/dl (-34%) but there was no improvement in vascular stiffness. Detailed analysis of lipoprotein subfractions revealed increased large, bouyant HDL(2) (3.3 mg/dl; P = 0.002) and decreased VLDL(1+2) (-32%; P < 0.0001), among subjects treated with combination therapy, that were not present with either therapy alone. ERN and P-OM3 alone improved characteristics of metabolic syndrome; however, whereas subjects on combination therapy did not have improved vascular stiffness, TG and HDL levels improved as did certain lipoprotein subfractions.
代谢综合征包括血脂异常和血管功能受损。由于缓释烟酸（ERN）和处方ω-3 酸乙酯（P-OM3）可独立改善这些特征，因此我们测试了它们联合使用的效果。60 名代谢综合征患者被随机分为双盲试验，分别接受 16 周的双重安慰剂、P-OM3（4 克/天）、ERN（2 克/天）或联合治疗。使用协方差分析（ANCOVA）测量和测试脂蛋白亚组分和血管终点。ERN 使 HDL 胆固醇从基线增加了 5.4mg/dl（P=0.04），使 TG 降低了 39mg/dl（-21%，P=0.003），并降低了血管硬度的测量指标——增强指数（augmentation index）3.5 个单位（P=0.04）。P-OM3 使 TG 降低了 26mg/dl（-13%，P=0.04）。联合治疗使 HDL 胆固醇增加了 7.8mg/dl（P=0.002），使 TG 降低了 72mg/dl（-34%），但血管硬度没有改善。脂蛋白亚组分的详细分析显示，与单独使用任何一种药物相比，联合治疗组的大而浮的 HDL（2）增加了 3.3mg/dl（P=0.002），VLDL（1+2）减少了 32%（P<0.0001）。ERN 和 P-OM3 单独治疗可改善代谢综合征的特征；然而，联合治疗组的血管僵硬没有改善，而 TG 和 HDL 水平以及某些脂蛋白亚组分得到了改善。
