American Journal of Clinical Nutrition, Vol 65, 1874-1881, Copyright © 1997 by The American Society for Clinical Nutrition, Inc

ORIGINAL RESEARCH COMMUNICATIONS

N-3 fatty acids do not lead to an increased diabetic risk in patients with hyperlipidemia and abnormal glucose tolerance. Italian Fish Oil Multicenter Study

CR Sirtori, R Paoletti, M Mancini, G Crepaldi, E Manzato, A Rivellese, F Pamparana and E Stragliotto
University of Milano, Center E Grossi Paoletti, Institute of Pharmacological Science, Italy. Sirtori@isfunix.farma.unimi.it

A multicenter, randomized, double-blind, place-bo-controlled study evaluated the possible worsening of glycemic control after a moderate daily intake of n-3 fatty acid ethyl esters in patients with hypertriglyceridemia with and without glucose intolerance or diabetes. A total of 935 patients of both sexes in 63 Italian clinical centers were selected; 55% had either impaired glucose tolerance or non-insulin- dependent diabetes mellitus (NIDDM). They received for 2 mo either 1 g n-3 ethyl esters three times a day or a corresponding placebo, followed by 4 mo of either 1 g n-3 ethyl esters twice a day or placebo. In addition to the complete lipid and lipoprotein evaluation, patients with impaired glucose tolerance also underwent an oral-glucose- tolerance test; in patients with NIDDM, serum insulin and glycated hemoglobin (Hb A1c) concentrations were determined. Plasma triacylglycerol concentrations decreased significantly, up to 21.53% at 6 mo compared with baseline (decreased 15% compared with placebo), with a tendency toward a progressive reduction with time. There was no evidence for a different response in patients with either NIDDM or impaired glucose tolerance. Among NIDDM patients, the triacylglycerol reduction was greater in those with high-density-lipoprotein cholesterol < or = 0.91 mmol/L. There was no alteration in the major glycemic indexes: fasting glucose, Hb A1c, insulinemia, and oral glucose tolerance in patients with impaired glucose tolerance or NIDDM after treatment with n-3 ethyl esters. Treatment with a moderate daily dose of n-3 ethyl esters over a prolonged period of time significantly reduced triacylglycerol concentrations without any worsening of glucose tolerance in patients with hypertriglyceridemia with and without impaired glycemic regulation.

This article has been cited by other articles:

				R. De Caterina, R. Madonna, A. Bertolotto, and E. B. Schmidt n-3 Fatty Acids in the Treatment of Diabetic Patients: Biological rationale and clinical data Diabetes Care, April 1, 2007; 30(4): 1012 - 1026. [Full Text] [PDF]

				I. L Mostad, K. S Bjerve, M. R Bjorgaas, S. Lydersen, and V. Grill Effects of n-3 fatty acids in subjects with type 2 diabetes: reduction of insulin sensitivity and time-dependent alteration from carbohydrate to fat oxidation. Am. J. Clinical Nutrition, September 1, 2006; 84(3): 540 - 550. [Abstract] [Full Text] [PDF]

				I. J. A. M. Jonkers, A. H. M. Smelt, H. M. G. Princen, F. Kuipers, J. A. Romijn, R. Boverhof, A. A. M. Masclee, and F. Stellaard Fish Oil Increases Bile Acid Synthesis in Male Patients with Hypertriglyceridemia J. Nutr., April 1, 2006; 136(4): 987 - 991. [Abstract] [Full Text] [PDF]

				I. A Castro, L. P Barroso, and P. Sinnecker Functional foods for coronary heart disease risk reduction: a meta-analysis using a multivariate approach Am. J. Clinical Nutrition, July 1, 2005; 82(1): 32 - 40. [Abstract] [Full Text] [PDF]

				M. J. Franz, J. P. Bantle, C. A. Beebe, J. D. Brunzell, J.-L. Chiasson, A. Garg, L. A. Holzmeister, B. Hoogwerf, E. Mayer-Davis, A. D. Mooradian, et al. Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications Diabetes Care, January 1, 2002; 25(1): 148 - 198. [Full Text] [PDF]

				R. U Almario, V. Vonghavaravat, R. Wong, and S. E Kasim-Karakas Effects of walnut consumption on plasma fatty acids and lipoproteins in combined hyperlipidemia Am. J. Clinical Nutrition, July 1, 2001; 74(1): 72 - 79. [Abstract] [Full Text] [PDF]

				P N Durrington, D Bhatnagar, M I Mackness, J Morgan, K Julier, M A Khan, and M France An omega-3 polyunsaturated fatty acid concentrate administered for one year decreased triglycerides in simvastatin treated patients with coronary heart disease and persisting hypertriglyceridaemia Heart, May 1, 2001; 85(5): 544 - 548. [Abstract] [Full Text]

				S. Westphal, M. Orth, A. Ambrosch, K. Osmundsen, and C. Luley Postprandial chylomicrons and VLDLs in severe hypertriacylglycerolemia are lowered more effectively than are chylomicron remnants after treatment with n-3 fatty acids Am. J. Clinical Nutrition, April 1, 2000; 71(4): 914 - 920. [Abstract] [Full Text] [PDF]

				J. Eritsland Safety considerations of polyunsaturated fatty acids Am. J. Clinical Nutrition, January 1, 2000; 71(1): 197S - 201S. [Abstract] [Full Text] [PDF]