Effect of omega-3 supplements on plasma apolipoprotein C-III concentrations: a systematic review and meta-analysis of randomized controlled trials |
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| Authors: | Amirhossein Sahebkar Luis E. Simental-Mendía Dimitri P. Mikhailidis Matteo Pirro Maciej Banach Cesare R. Sirtori |
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| Affiliation: | 1. Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran;2. Biomedical Research Unit, Mexican Social Security Institute, Durango, Mexico;3. Department of Clinical Biochemistry, Royal Free Hospital Campus, University College London Medical School, University College London (UCL), London, United Kingdom;4. Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Medicine, University of Perugia, Perugia, Italy;5. Department of Hypertension, WAM University Hospital in Lodz, Medical University of Lodz, Lodz, Poland;6. Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland;7. Centro Dislipidemie, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milan, Italy |
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| Abstract: | ![]()
AbstractBackground: Apolipoprotein C-III (apo C-III) is a key regulator of triglycerides metabolism. The aim of this meta-analysis was to assess the effect of fish omega-3 polyunsaturated fatty acids (PUFAs) on apo C-III levels.Methods: Randomized placebo-controlled trials investigating the impact of omega-3 on apo C-III levels were searched in PubMed-Medline, SCOPUS, Web of Science and Google Scholar. A random-effects model and generic inverse variance method were used for quantitative data synthesis. Sensitivity analysis was conducted using the leave-one-out method. A weighted random-effects meta-regression was performed to evaluate the impact of potential confounders on glycemic parameters.Results: This meta-analysis comprising 2062 subjects showed a significant reduction of apo C-III concentrations following treatment with omega-3 (WMD: ?22.18?mg/L, 95% confidence interval: ?31.61, ?12.75, p?2: 88.24%). Subgroup analysis showed a significant reduction of plasma apo C-III concentrations by eicosapentaenoic acid (EPA) ethyl esters but not omega-3 carboxylic acids or omega-3 ethyl esters. There was a greater apo C-III reduction with only EPA as compared with supplements containing EPA and docosahexaenoic acid (DHA) or only DHA. A positive association between the apo C-III-lowering effect of omega-3 with baseline apo C-III concentrations and treatment duration was found.Conclusions: This meta-analysis has shown that omega-3 PUFAs might significantly decrease apo C-III.- Key messages
Omega-3 PUFA supplements significantly reduce apo C-III plasma levels, particularly in hypertriglyceridemic patients when applied in appropriate dose (more than 2?g/day) Triglyceride (TG)-lowering effect is achieved via peroxisome proliferator-activated receptors α Further studies should address the effect of omega-3 PUFAs alone or with other lipid-lowering drugs in order to provide a final answer whether apo C-III could be an important target for prevention of cardiovascular disease New apo C-III antisense oligonucleotide drug (Volanesorsen) showed to be promising in decreasing elevated TGs by reducing levels of apo C-III mRNA
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| Keywords: | Omega-3 fatty acids PUFA eicosapentaenoic acid docosahexaenoic acid cardiovascular disease coronary heart disease |
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