Omega-3 Fatty Acids May Reduce Triglycerides !!!
Long-term use of omega-3 fatty acid supplements has been associated with reduced levels of triglycerides and the C-reactive protein (CRP) of inflammatory biomarkers in HIV-positive people with suppressed viral load, according to research presented in the week Spent at IDWeek 2016 in New Orleans.
As people living with HIV live longer thanks to effective antiretroviral therapy (ART), chronic diseases such as cardiovascular disease and cancer are a growing concern. Research suggests that chronic inflammation and excessive immune activation contribute to the increased risk of these non-AIDS-related conditions in this population, even when taking ART effectively, with good adherence.
Gretchen Volpe of Tufts University School of Medicine and colleagues conducted a randomized, placebo-controlled study - the longest to date - of high-dose omega-3 fatty acids for people with HIV, assessing their long-term effects on levels of Lipids in the blood, inflammation, and vascular function. Omega-3 fatty acids - found in fish oil - are often taken to lower triglycerides.
The study included 117 participants in stable ART with high triglycerides (fasting level between 150 and 2500 mg / dl or random level> 200 mg / dl). About 80% were men and the average age was 51 years. The mean CD4 count was 648 cells / mm3 and 95% had undetectable viral load. Metabolic factors, smoking and alcohol use, HIV status, and baseline lipids and vascular function were similar in both groups. About 30% of the subjects in the study, in both groups, used statins, but people who regularly used fish oil were excluded.
Participants were randomly assigned to receive 4 daily grams of omega-3 or placebo fatty acids for 24 months. They used the Lovaza formulation, which contains a combination of ethyl esters of omega-3, mainly eicosapentaenoic acid NT1 And docosahexaenoic acid NT2 (465mg and 375mg, respectively, per 1 gram capsule).
The formulation is approved to reduce triglyceride levels in people with severe hypertriglyceridemia. All participants were also advised regarding a change to a lipid-lowering diet and to seek to maintain a stable weight.
After 33 people lost follow-up (a similar number in both arms), researchers analyzed 43 randomized people to the arm of the study that received omega-3 and 40 from the arm of this study to which delivery was attributed and placebo.
Primary outcomes were changes in triglycerides, high density lipoprotein cholesterol (HDL) and the marker of inflammation PCR. Researchers also looked at total cholesterol and low-density lipoprotein (LDL) as well as indicators of vascular function including brachial artery reactivity and arterial stiffness as measured by pulse wave velocity.
At 24 months, mean triglyceride levels decreased significantly more in the omega-3 arm compared to the placebo arm (-68 vs -22 mg / dl). Triglycerides decreased over 12 months in both arms but continued to decrease between the 12 and 24 months on the omega-3 arm as they reached a stable plateau in the placebo arm.
PCR decreased significantly in the omega-3 arm for 24 months, but not in the placebo arm (-0,3 vs + 0,6 mg / l). In both arms the PCR decreased in the first 12 months, but then increased between the 12 and the 24 months. CRP remained below baseline in the arm receiving omega-3, but rose above these acceptable levels in the placebo group.
There was no significant difference in HDL levels between the two treatment groups. There was also no significant difference in total or LDL cholesterol at any time, but there was a trend towards a greater reduction of total cholesterol in the omega-3 group in 24 months (-9,2 vs + 3,9 mg / dl).
Brachial artery reactivity did not differ significantly between the two groups. There was a tendency for reduction of carotid-femoral artery stiffness during 24 months in the omega-3 arm, but the difference did not reach statistical significance (-46 vs + 18 ms-1).
Omega-3 fatty acids were generally safe and well tolerated, and serious adverse events did not differ between the two treatment groups, Volpe reported. Accession was considered "viable" over the two-year period.
The long-term supplementation of omega-3 fatty acids seems beneficial to people with HIV and their effectiveness may increase over time, the researchers concluded. Omega-3 "fatty acids can reduce inflammation as measured by PCR, even for those whose CRP is within the normal range at the baseline."
"Taking into account our success in managing HIV infection, we are now aiming to optimize the duration and quality of life of people living with HIV / AIDS so that interventions with omega-3 fatty acids can be beneficial" , Wrote in their abstract.
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