Changes in Lipid Parameters with Added Omega-3 Fatty Acids on Hmg-CoA Reductase Inhibitors in Combined Hyperlipidaemia

Öz

Objective: Long chain fatty acids especially omega-3 (OM3) fatty acids are very important for protection of cardiac health and fighting against myocardial infarction. We evaluated the effects of OM3 fatty acids added on HMG-CoA reductase inhibitors in patients with combined hyperlipideamia. Materials and Methods: Fifty five patients with coronary artery disease who have combined hyperlipidaemia and thought to be treated with HMG-CoA reductase inhibitors were included. Patients were divided in two groups; atorvastatin 20 mg/day was given to Group A (mean age: 49±5 yrs, n:27, 11 female) and atorvastatin 20mg/day+OM3 fatty acids 3gr/day were given to Group B (mean age: 51±9 yrs, n:28; 13 female) for four weeks. At the end of this period; levels of total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C) and triglyceride (TG) were measured once more and results were compared. Results: Basal clinical characteristics of the groups were similar (p>0.05). During the follow-up period in group A we saw a significant decrease in TC (28%, p:0.02), LDL (35%, p:0.001), TG (%28, p:0.01) and an insignificant increase in HDL (%5, p:0.067). Patients in group B had 39% decrease in TC (p:0.001), 40% decrease in LDL (p:0.001), 41% decrease in TG (p:0.001) and they had a 19% increase in HDL (p:0.02). By adding OM3; reduction rate in TC and TG levels in group B were significantly higher than the results in Group A (p

Anahtar Kelimeler

• -

Omega-3 Yağ Asitlerinin Hmg-KoA Redüktaz İnhibitörlerine İlave Edilmesiyle Lipid Parametrelerinde Gözlenen Değişiklikler

Öz

Amaç: Ölümcül miyokart enfarktüsüne karşı, kalp sağlığının sürdürülmesi ve korunmasında uzun zincirli, özellikle de omega-3 gibi yağ asitlerinin önemli rol üstlendikleri bildirilmektedir. Çalışmamızda hiperlipidemi nedeniyle HMG-KoA redüktaz inhibitörü başlanan hastalara omega-3 yağ asitlerinin ilave edilmesiyle lipid profilindeki değişiklikler araştırıldı Gereç ve Yöntemler: Çalışmaya, hiperlipidemi nedeniyle HMG-KoA redüktaz inhibitörü başlanması planlanan toplam 55 vaka alındı. Daha sonra 4 hafta süreyle hastaların bir bölümüne (Grup A, yaş ortalaması (YO):49±5 yıl; n:27, 11 kadın) atorvastatin 20 mg/gün, diğer bir bölümüne ise (Grup B, YO:51±9 yıl, n:28, 13 kadın) atorvastatin 20 mg/gün+omega-3 yağ asidi 3gr/gün verildi. Bu sürecin sonunda ise, tüm hastaların total kolesterol (TK), LDL kolesterol, HDL kolesterol (HDL) ve trigliserid (TG) gibi lipid parametreleri tekrar incelenerek gruplar arasında fark olup olmadığı araştırıldı. Bulgular: Grupların bazal klinik özellikleri benzerdi.(P>0,05). Takip süresince; Grup A'daki hastaların TK'de %28 (P:0,02), LDL'de %35 (p:0,001), TG'de %28 (p:0,01) düşme ve HDL'de %5 (p:0,067) artma saptandı. Grup B'deki hastaların TK'de %39 (p:0,001), LDL'de %40 (p.0,001), TG'de %41 (p:0,001) düşme ve HDL'de %19 (p:0,02) artma gözlendi. Tedavi sonrası özellikle Grup-B'de gözlenen TK'de ve TG'de düşme oranı grup A'dan belirgin olarak daha yüksekti (p

Anahtar Kelimeler

• Hiperlipidemi, omega-3 yağ asitleri, HMG-KoA redüktaz inhibitörleri

Kaynakça

1. Defilipps A, Sperling S. Understanding omega-3’s. Am Heart J 2006; 151:564-70.
2. Pierce LR, Wysowski DK, Gross TP. Myopathy and Rhabdomyolysis associated with lovastation- gemfibrozil combination therapy. JAMA 1990; 264:71-5.
3. Mori TA, Burke V, Puddey IB, Watts GF, O’Neal DN et al. Purified eicosapentaenoic and docosahexaenoic acids have differential effects on serum lipids and lipoproteins, LDL particle size, glucose, and insulin in mildly hyperlipidemic men. Am J Clin Nutr 2000; 71:1085-94.
4. Bhatnagar D, Mackness MI, Durrington PN. Treatment of mixed hyperlipidaemia using a combination of omega-3 fatty acids and HMG Co A reductase inhibitor. E Heart J 2001; 3: D53-8.
5. Nordoy A, Bonaa KH, Nilsen H, Berge RK, Hansen JB, Ingebretsen OC. Effects of Simvastatin and omega-3 fatty acids on plasma lipoproteins and lipid peroxidation in patients with combined hyperlipidaeamia. J Intern Med 1998; 243: 163-70.
6. Contacos C, Barter PJ, Sullivan DR. Effect of pravastatin and omega-3 fatty acids on plasma lipids and lipoproteins in patients with combined hyperlipidaemia. Arterioscl Thromb Vas Biol 1993; 13:1775-62.
7. Nordoy A, Hansen JB, Brox J, Svenson B. Effects of atorvastatin and omega-3 fatty acids on LDL subfractions and postprandial hyperlipemia in patients with combined hyperlipemia. Nutr Metab Cardiovasc Dis 2001: 11; 7-16.
8. Friedewall WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative centrifuge. Clin Chem 1972; 18:499-502. (Abstract).

9. Pownall HJ, Brauchi D, Kilinc C, et al. Correlation of serum triglyceride and its reduction by omega-3 fatty acids with lipid transfer activity and the neutral lipid compositions of high- density and low -density lipoproteins. Atherosclerosis 1999; 143: 285-97.
10. Haris WS, n-3 Fatty acids and serum lipoproteins: human studies. Am J Clin Nutr 1997; 65(suppl); 1645S-1665S.
11. Harris WS. Fish oils and plasma lipid and lipoprotein metabolism in humans: a critical review. J Lipid Res 1989; 30:785-807.
12. Park Y, Harris WS. Omega-3 fatty acid supplementation accelerates chylomicron triglyceride clearence. J Lipid Res 2003; 44:455-63.
13. Durrington PN, Bhatnagar D, Mackness MI, Morgan J, Julier K, Khan MA, France M. 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 2001; 85:544-48.
14. Kabul Tarihi: 11.04.2009