Harris W S, Ginsberg H N, Arunakul N, Shachter N S, Windsor S L, Adams M, Berglund L, Osmundsen K
Department of Medicine, University of Kansas Medical Center, Kansas City, USA.
J Cardiovasc Risk. 1997 Oct-Dec;4(5-6):385-91.
Severe hypertriglyceridemia is a risk factor for acute pancreatitis, therefore decreasing serum triglyceride concentrations is an important component of risk management. Omega-3 fatty acids are well known hypotriglyceridemic agents, but their efficacy in severe forms of the disorder is not well documented. Our objective was to examine the effects of Omacor, a drug composed of 85% omega-3 fatty acid ethyl esters.
Forty-two patients with triglyceride concentrations between 5.65 and 22.60 mmol/l (500 and 2000 mg/dl) were studied in a prospective, double-blind, placebo-controlled trial of Omacor (4 g/day for 4 months).
Compared with baseline values, Omacor significantly reduced mean triglyceride concentrations by 45% (P<0.00001), cholesterol by 15% (P< 0.001), very-low-density lipoprotein cholesterol by 32% (P< 0.0001) and cholesterol:high density lipoprotein (HDL) cholesterol ratio by 20% (P=0.0013), and increased HDL cholesterol by 13% (P=0.014) and low-density lipoprotein cholesterol by 31% (P=0.0014). The placebo had no effect on these parameters. Omacor was well tolerated and no patient discontinued medication because of side effects.
Four capsules of Omacor per day markedly decreased triglyceride concentrations in patients with severe hypertriglyceridemia. The availability of a potent and safe omega-3 fatty acid preparation for this patient population should diminish the risk for acute pancreatitis, and may also reduce the long-term risk for cardiovascular disease.
严重高甘油三酯血症是急性胰腺炎的一个危险因素,因此降低血清甘油三酯浓度是风险管理的重要组成部分。ω-3脂肪酸是众所周知的降甘油三酯药物,但其在该疾病严重形式中的疗效尚无充分记录。我们的目的是研究Omacor(一种由85%ω-3脂肪酸乙酯组成的药物)的效果。
在一项前瞻性、双盲、安慰剂对照试验中,对42名甘油三酯浓度在5.65至22.60 mmol/l(500至2000 mg/dl)之间的患者进行了研究,给予Omacor(4克/天,持续4个月)。
与基线值相比,Omacor显著降低了平均甘油三酯浓度45%(P<0.00001),胆固醇降低了15%(P<0.001),极低密度脂蛋白胆固醇降低了32%(P<0.0001),胆固醇与高密度脂蛋白(HDL)胆固醇比值降低了20%(P=0.0013),并使HDL胆固醇升高了13%(P=0.014),低密度脂蛋白胆固醇升高了31%(P=0.0014)。安慰剂对这些参数无影响。Omacor耐受性良好,并无人因副作用而停药。
每天服用四粒Omacor可显著降低严重高甘油三酯血症患者的甘油三酯浓度。为该患者群体提供一种有效且安全的ω-3脂肪酸制剂应可降低急性胰腺炎的风险,并且也可能降低心血管疾病的长期风险。