Schectman G, Kaul S, Kissebah A H
Clinical Research Center, Medical College of Wisconsin, Milwaukee 53226.
Arteriosclerosis. 1989 May-Jun;9(3):345-54. doi: 10.1161/01.atv.9.3.345.
Previous studies have demonstrated a variable effect of fish oil on low density lipoprotein (LDL) cholesterol and apolipoprotein (apo) B levels, particularly in hypertriglyceridemic subjects. Since heterogeneity of LDL composition and metabolism in hypertriglyceridemic subjects is well described, the present study was undertaken to determine if the response of LDL to dietary fish-oil supplementation is dependent upon pretreatment differences in LDL composition. A single-blind, cross-over design was used with 18 hypertriglyceridemic subjects, who were given supplements of a safflower-oil placebo or a fish-oil concentrate (4.0 g omega-3 fatty acids; [F4 dose]) for 1 month. Sixteen subjects then received an additional month of fish-oil supplementation at a higher dose (7.5 g omega-3 fatty acids [F7.5 dose]). The initial LDL cholesterol/apo B ratio, an index of LDL composition, was correlated positively with changes in LDL apo B levels (F4.0 dose: r = 0.41, p = 0.06; F7.5 dose: r = 0.51, p = 0.03) and negatively with changes in LDL cholesterol concentrations (F4.0 dose: r = -0.51, p = 0.01; F7.5 dose: r = -0.50, p = 0.02). Twelve subjects with LDL cholesterol/apo B ratios above 1.4 had large increases in LDL apo B (51% at both doses, p less than 0.05) but much smaller changes in LDL cholesterol levels during fish-oil treatment. Six subjects with LDL cholesterol/apo B ratios below 1.4 showed a trend toward increased LDL cholesterol (12% increase from baseline at F4 dose, 10% increase from baseline at F7.5 dose, p greater than 0.05) but not in LDL apo B levels during fish-oil therapy. These data suggest that LDL responses to fish oil may be linked to underlying differences in LDL composition and, presumably, to differences in LDL metabolic behavior.
以往研究表明，鱼油对低密度脂蛋白（LDL）胆固醇和载脂蛋白（apo）B水平有不同影响，尤其是在高甘油三酯血症患者中。鉴于高甘油三酯血症患者LDL组成和代谢的异质性已得到充分描述，本研究旨在确定LDL对膳食补充鱼油的反应是否取决于LDL组成的预处理差异。采用单盲交叉设计，对18名高甘油三酯血症患者进行研究，给予他们红花油安慰剂或鱼油浓缩物补充剂（4.0克ω-3脂肪酸；[F4剂量]），为期1个月。然后，16名受试者接受了额外一个月的更高剂量鱼油补充（7.5克ω-3脂肪酸[F7.5剂量]）。初始LDL胆固醇/apo B比值是LDL组成的一个指标，与LDL apo B水平的变化呈正相关（F4.0剂量：r = 0.41，p = 0.06；F7.5剂量：r = 0.51，p = 0.03），与LDL胆固醇浓度的变化呈负相关（F4.0剂量：r = -0.51，p = 0.01；F7.5剂量：r = -0.50，p = 0.02）。12名LDL胆固醇/apo B比值高于1.4的受试者在鱼油治疗期间LDL apo B大幅增加（两种剂量下均增加51%，p < 0.05），但LDL胆固醇水平变化较小。6名LDL胆固醇/apo B比值低于1.4的受试者在鱼油治疗期间LDL胆固醇有升高趋势（F4剂量时较基线升高12%，F7.5剂量时较基线升高10%，p > 0.05），但LDL apo B水平无变化。这些数据表明，LDL对鱼油的反应可能与LDL组成的潜在差异有关，大概也与LDL代谢行为的差异有关。
