Vine Donna, Proctor Ethan, Weaver Olivia, Ghosh Mahua, Maximova Katerina, Proctor Spencer
Metabolic and Cardiovascular Diseases Laboratory, University of Alberta, Edmonton, AB T6G 2R3, Canada.
Department of Endocrinology and Metabolism, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada.
J Endocr Soc. 2021 Jun 19;5(9):bvab114. doi: 10.1210/jendso/bvab114. eCollection 2021 Sep 1.
Women with polycystic ovary syndrome (PCOS) have increased incidence of atherogenic dyslipidemia and cardiovascular disease (CVD). Interventions targeting atherogenic dyslipidemia to reduce CVD risk are limited in women with PCOS.
This pilot study was conducted to determine the effect of 12 weeks of high dose fish oil (FO), metformin, and FO as an adjunct to metformin (FO-metformin) therapy on fasting and nonfasting plasma lipids and ApoB-remnants in young women with the metabolic syndrome (MetS) and PCOS.
In this open-label parallel pilot trial, women with MetS and PCOS (18-30 years of age) were randomized into 1 of 3 interventions: (1) FO; (2) metformin; and (3) FO-metformin. Plasma lipids and ApoB (48 and 100)-lipoproteins and triglycerides (TG) were measured in the fasted and postprandial state following a high-fat meal at baseline and postintervention.
FO-metformin significantly lowered fasting plasma TG by >40% compared with FO and metformin treatments. Fasting plasma apoB48 was lowered 40% in FO-metformin and 15% in the FO groups from baseline to postintervention. ApoB48 area under the curve (ApoB48), ApoB48 incremental AUC (ApoB48), ApoB100, and ApoB100 decreased in all groups from baseline to postintervention; however, these findings did not reach statistical significance.
The findings of this pilot trial show that high dose FO and FO-metformin combination therapy tend to lower fasting and postprandial plasma TG and ApoB-lipoprotein remnants compared with metformin; however, the study is limited by small sample size. These results may be clinically significant in individuals with PCOS for management of atherogenic dyslipidemia.
多囊卵巢综合征（PCOS）女性发生致动脉粥样硬化性血脂异常和心血管疾病（CVD）的几率增加。针对致动脉粥样硬化性血脂异常以降低CVD风险的干预措施在PCOS女性中有限。
本初步研究旨在确定12周高剂量鱼油（FO）、二甲双胍以及FO作为二甲双胍辅助治疗（FO-二甲双胍）对患有代谢综合征（MetS）和PCOS的年轻女性空腹和非空腹血脂及载脂蛋白B残粒的影响。
在这项开放标签平行初步试验中，患有MetS和PCOS（18 - 30岁）的女性被随机分为3种干预措施中的一种：（1）FO；（2）二甲双胍；（3）FO-二甲双胍。在基线和干预后，高脂餐后的空腹和餐后状态下测量血脂、载脂蛋白B（48和100）-脂蛋白以及甘油三酯（TG）。
与FO和二甲双胍治疗相比，FO-二甲双胍使空腹血浆TG显著降低>40%。从基线到干预后，FO-二甲双胍组空腹血浆载脂蛋白B48降低40%，FO组降低15%。从基线到干预后，所有组的载脂蛋白B48曲线下面积（ApoB48）、载脂蛋白B48增量曲线下面积（ApoB48）、载脂蛋白B100和载脂蛋白B100均下降；然而，这些结果未达到统计学意义。
本初步试验结果表明，与二甲双胍相比，高剂量FO和FO-二甲双胍联合治疗倾向于降低空腹和餐后血浆TG以及载脂蛋白B-脂蛋白残粒；然而，该研究受样本量小的限制。这些结果对于PCOS个体管理致动脉粥样硬化性血脂异常可能具有临床意义。
