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ω-3脂肪酸联合非诺贝特对高甘油三酯血症患者的血管和代谢影响

Vascular and metabolic effects of omega-3 fatty acids combined with fenofibrate in patients with hypertriglyceridemia.

作者信息

Koh Kwang Kon, Oh Pyung Chun, Sakuma Ichiro, Lee Yonghee, Han Seung Hwan, Shin Eak Kyun

机构信息

Cardiology, Gachon University Gil Medical Center, Incheon, Republic of Korea; Gachon Cardiovascular Research Institute, Incheon, Republic of Korea.

Cardiology, Gachon University Gil Medical Center, Incheon, Republic of Korea; Gachon Cardiovascular Research Institute, Incheon, Republic of Korea.

出版信息

Int J Cardiol. 2016 Oct 15;221:342-6. doi: 10.1016/j.ijcard.2016.07.038. Epub 2016 Jul 5.

Abstract

BACKGROUND

Effects of omega-3 fatty acids (n-3 FA) combined with fenofibrate are not yet investigated, compared with fenofibrate.

METHODS

This was a randomized, single-blind, placebo-controlled, parallel study. Age, sex, and body mass index were matched among groups. All patients were recommended to maintain a low fat diet. Fifty patients with hypertriglyceridemia in each group were given placebo, n-3 FA 2g+fenofibrate 160mg (combination), or fenofibrate 160mg, respectively daily for 2months.

RESULTS

Placebo, combination, and fenofibrate significantly decreased triglycerides by 7%, 41% and 30%, respectively and triglycerides/HDL cholesterol ratio by 11%, 45% and 32%, respectively relative to baseline measurements (all P<0.05 by paired t-test). When compared with placebo and fenofibrate, these with combination were significant (P<0.001 by ANOVA). When compared with placebo, both combination and fenofibrate significantly decreased apolipoprotein B and non-HDL cholesterol and improved flow-mediated dilation and reduced CRP and fibrinogen (all P<0.05 by ANOVA), however, there were no significant differences between combination and fenofibrate. When compared with placebo, both combination and fenofibrate significantly reduced insulin and glucose (both P<0.05 by ANOVA), and improved insulin sensitivity (P=0.005 by ANOVA). However, there were no significant differences between combination and fenofibrate.

CONCLUSIONS

When compared with fenofibrate, combination significantly decreased triglycerides and triglycerides/HDL cholesterol ratio. Otherwise, combination and fenofibrate significantly reduced apolipoprotein B and non-HDL cholesterol and improved flow-mediated dilation and reduced CRP and fibrinogen to a similar extent. Also, combination and fenofibrate significantly improved insulin sensitivity to a similar extent by reducing insulin and glucose in patients with hypertriglyceridemia.

摘要

背景

与非诺贝特相比,ω-3脂肪酸(n-3 FA)联合非诺贝特的效果尚未得到研究。

方法

这是一项随机、单盲、安慰剂对照的平行研究。各组之间年龄、性别和体重指数相匹配。所有患者均被建议维持低脂饮食。每组50例高甘油三酯血症患者分别每日服用安慰剂、n-3 FA 2g+非诺贝特160mg(联合用药组)或非诺贝特160mg,持续2个月。

结果

与基线测量值相比,安慰剂组、联合用药组和非诺贝特组的甘油三酯分别显著降低了7%、41%和30%,甘油三酯/高密度脂蛋白胆固醇比值分别显著降低了11%、45%和32%(配对t检验,P均<0.05)。与安慰剂组和非诺贝特组相比,联合用药组差异显著(方差分析,P<0.001)。与安慰剂组相比,联合用药组和非诺贝特组均显著降低了载脂蛋白B和非高密度脂蛋白胆固醇,改善了血流介导的血管舒张,降低了CRP和纤维蛋白原(方差分析,P均<0.05),然而联合用药组和非诺贝特组之间无显著差异。与安慰剂组相比,联合用药组和非诺贝特组均显著降低了胰岛素和血糖水平(方差分析,P均<0.05),并改善了胰岛素敏感性(方差分析,P=0.

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