Gidding Samuel S, Prospero Carol, Hossain Jobayer, Zappalla Frances, Balagopal Prabhakaran Babu, Falkner Bonita, Kwiterovich Peter
Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE; Division of Nephrology, Department of Internal Medicine, Thomas Jefferson University, Philadelphia, PA.
Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE.
J Pediatr. 2014 Sep;165(3):497-503.e2. doi: 10.1016/j.jpeds.2014.05.039. Epub 2014 Jul 7.
To determine the efficacy of 4 g/day fish oil to lower triglycerides and impact lipoprotein particles, inflammation, insulin resistance, coagulation, and thrombosis.
Participants (n = 42, age 14 ± 2 years) with hypertriglyceridemia and low-density lipoprotein (LDL) cholesterol <160 mg/dL were enrolled in a randomized, double-blind, crossover trial comparing 4 g of fish oil daily with placebo. Treatment interval was 8 weeks with a 4-week washout. Lipid profile, lipoprotein particle distribution and size, glucose, insulin, high-sensitivity C-reactive protein, interleukin-6, fibrinogen, plasminogen activator inhibitor-1, and thrombin generation were measured.
Baseline lipid profile was total cholesterol 194 (5.4) mg/dL (mean [SE]), triglycerides 272 (21) mg/dL, high-density lipoprotein cholesterol 39 (1) mg/dL, and LDL cholesterol 112 (3.7) mg/dl. LDL particle number was 1614 (60) nmol/L, LDL size was 19.9 (1.4) nm, and large very low-density lipoprotein/chylomicron particle number was 9.6 (1.4) nmol/L. Triglycerides decreased on fish oil treatment but the difference was not significant compared with placebo (-52 ± 16 mg/dL vs -16 ± 16 mg/dL). Large very low-density lipoprotein particle number was reduced (-5.83 ± 1.29 nmol/L vs -0.96 ± 1.31 nmol/L; P < .0001). There was no change in LDL particle number or size. There was a trend towards a lower prothrombotic state (lower fibrinogen and plasminogen activator inhibitor-1; .10 > P > .05); no other group differences were seen.
In children, fish oil (4 g/day) lowers triglycerides slightly and may have an antithrombotic effect but has no effect on LDL particles.
确定每日4克鱼油降低甘油三酯以及对脂蛋白颗粒、炎症、胰岛素抵抗、凝血和血栓形成的影响。
招募42名（年龄14±2岁）患有高甘油三酯血症且低密度脂蛋白（LDL）胆固醇<160 mg/dL的参与者，进行一项随机、双盲、交叉试验，比较每日4克鱼油与安慰剂的效果。治疗间隔为8周，洗脱期为4周。测量血脂谱、脂蛋白颗粒分布和大小、血糖、胰岛素、高敏C反应蛋白、白细胞介素-6、纤维蛋白原、纤溶酶原激活物抑制剂-1和凝血酶生成。
基线血脂谱为总胆固醇194（5.4）mg/dL（均值[标准误]）、甘油三酯272（21）mg/dL、高密度脂蛋白胆固醇39（1）mg/dL、LDL胆固醇112（3.7）mg/dl。LDL颗粒数为1614（60）nmol/L，LDL大小为19.9（1.4）nm，大极低密度脂蛋白/乳糜微粒颗粒数为9.6（1.4）nmol/L。鱼油治疗后甘油三酯降低，但与安慰剂相比差异不显著（-52±16 mg/dL对-16±16 mg/dL）。大极低密度脂蛋白颗粒数减少（-5.83±1.29 nmol/L对-0.96±1.31 nmol/L；P<.0001）。LDL颗粒数和大小无变化。有降低血栓前状态的趋势（纤维蛋白原和纤溶酶原激活物抑制剂-1降低；.10>P>.05）；未观察到其他组间差异。
在儿童中，鱼油（每日4克）可轻微降低甘油三酯，可能具有抗血栓作用，但对LDL颗粒无影响。
