Gupta Ashish, Alkhalil Mohammad
Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK.
Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE1 7RU, UK.
J Clin Med. 2023 May 30;12(11):3758. doi: 10.3390/jcm12113758.
Omega-3 polyunsaturated fatty acids (PUFAs) were early established as therapeutic option for patients with high triglyceride levels. Their effects on lipoprotein particles, including a reduction in very low-density lipoprotein and a shift from small to large low-density lipoprotein, is increasingly recognised. This is coupled with their ability to be incorporated within the cellular membrane, leading to plaque stability and anti-inflammatory effects. Nonetheless, recent clinical trials have not been consistent in demonstrating the potential cardioprotective effects of omega-3 fatty acids. This is despite the circumstantial evidence from imaging studies illustrating the stabilising effects on atherosclerotic plaques and slowing of plaque progression. In this article, we will review the effects of omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), on lipid biomarkers, atherosclerotic plaque features, and clinical outcome studies and provide a mechanistic role in managing residual risk of atherosclerosis. This will provide better insight into the inconsistency of the recently reported clinical outcome studies.
ω-3多不饱和脂肪酸（PUFAs）很早就被确立为高甘油三酯水平患者的治疗选择。它们对脂蛋白颗粒的作用，包括降低极低密度脂蛋白以及使低密度脂蛋白从小颗粒向大颗粒转变，越来越受到认可。这与它们能够整合到细胞膜中、导致斑块稳定和产生抗炎作用有关。尽管如此，最近的临床试验在证明ω-3脂肪酸的潜在心脏保护作用方面并不一致。尽管影像学研究的间接证据表明其对动脉粥样硬化斑块有稳定作用且能减缓斑块进展，但仍出现这种情况。在本文中，我们将综述ω-3脂肪酸、二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）对脂质生物标志物、动脉粥样硬化斑块特征以及临床结局研究的影响，并阐述其在管理动脉粥样硬化残余风险中的机制作用。这将有助于更好地理解最近报道的临床结局研究结果不一致的情况。
