Advertisement

Comparison of effects of N-3 to N-6 fatty acids on serum level of lipoprotein(a) in patients with coronary artery disease

  • Wolfgang Herrmann
    Correspondence
    Address for reprints: Wolfgang Herrmann, PhD, Institut fu¨r Klinische Chemie und Laboratoriumsmedizin der Universita¨t Regensburg, D-93042 Regensburg, Germany.
    Affiliations
    From the Institut fu¨r Klinische Chemie und Laboratoriumsmedizin der Universita¨t Regensburg, Regensburg, Germany

    From the Ulrichsheimer Kurklinik, Bad Wo¨rishofen, Germany

    From the Institut fu¨r Medizinische Biochemie der Universita¨t Graz, Graz, Austria
    Search for articles by this author
  • Ju¨rgen Biermann
    Affiliations
    From the Institut fu¨r Klinische Chemie und Laboratoriumsmedizin der Universita¨t Regensburg, Regensburg, Germany

    From the Ulrichsheimer Kurklinik, Bad Wo¨rishofen, Germany

    From the Institut fu¨r Medizinische Biochemie der Universita¨t Graz, Graz, Austria
    Search for articles by this author
  • Gert M. Kostner
    Affiliations
    From the Institut fu¨r Klinische Chemie und Laboratoriumsmedizin der Universita¨t Regensburg, Regensburg, Germany

    From the Ulrichsheimer Kurklinik, Bad Wo¨rishofen, Germany

    From the Institut fu¨r Medizinische Biochemie der Universita¨t Graz, Graz, Austria
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      The influence of dietary supplementation with n-3 versus n-6 fatty acids on plasma lipoprotein(a) (Lp[a]) levels was studied. Thirty-five male hospitalized patients with coronary artery disease were treated for 4 weeks with 12 g/day of fish oil (≈8.5 g of n-3 fatty acids) in combination with a 5, 000 kilojoule, 30% fat diet and moderate exercise. Eighteen control patients given the same dietary and training program were treated with 12 g/day of rapeseed oil. Plasma Lp(a), in addition to several lipids and lipoproteins, blood clotting factors, and platelet reactivity, were measured before and at the end of therapy. Results can be summarized as follows: total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B levels decreased significantly in both the rapeseed oil (−14.4%, −20.3%, −15.2%, respectively) and fish oil (−12.2%, −16.0%, and −14.2%, respectively) groups. Triglycerides decreased (−20.3%) and high-density lipoprotein cholesterol increased (+8.3%) significantly only in patients treated with fish oil. Plasma Lp(a) levels were reduced by 14% in the fish oil group, but unaffected in the rapeseed oil group. Patients treated with fish oil could be categorized into 2 subgroups: “responders”, with a reduction in Lp(a) by 24% and “nonresponders”, with a small nonsignificant increase in serum Lp(a). Responders and nonresponders exhibited a marked reduction in cholesterol, low-density lipoprotein cholesterol, apolipoprotein B, and triglycerides, and an increase in high-density lipoprotein3 cholesterol. There was a large reduction in tissue plasminogen activator in the fish oil group, which correlated significantly with reduction in Lp(a). Platelet number and aggregation behavior were not significantly changed in either group. No physiologic differences were seen between responders and nonresponders.
      To read this article in full you will need to make a payment

      References

        • Scanu AM
        • Fless GM
        Lipoprotein(a). Heterogeneity and biological relevance.
        J Clin Invest. 1990; 85: 1709-1715
        • Krempler F
        • Kostner GM
        • Bolzano K
        • Sandhofer F
        Lp(a) is not a metabolic product of other lipoproteins containing apolipoprotein B.
        Biochim Biophys Acta. 1979; 488: 417-431
        • Kostner GM
        • Klein G
        • Krempler F
        Can serum Lp(a) concentrations be lowered by drugs and/or diet?.
        in: Olsson AG Treatment of Hyperlipoproteinemias. Raven Press, New York1984: 151-156
        • Dahlen GH
        • Guyton JR
        • Attar M
        • Farmer JA
        • Kautz JA
        • Gotto AM
        Association of levels of lipoprotein Lp(a), plasma lipids and other lipoproteins with coronary artery disease documented by angiography.
        Circulation. 1986; 74: 758-765
        • Armstrong VW
        • Cremer P
        • Eberle E
        • Manke A
        • Schulze F
        • Wieland H
        • Kreuzer H
        • Seidel D
        The association between serum Lp(a) concentrations and angiographically assessed coronary atherosclerosis.
        Atherosclerosis. 1986; 62: 249-257
        • Hoefler G
        • Harnoncourt F
        • Paschke E
        • Mirt W
        • Pfeiffer KP
        • Kostner GM
        Lipoprotein(a): a risk factor for myocardial infarction.
        Arteriosclerosis. 1988; 8: 398-401
        • Berglund L
        Diet and drug therapy for lipoprotein(a).
        Curr Opin Lipidol. 1995; 6: 48-56
        • Mensink RP
        • Zock PL
        • Katan MB
        • Hornstra G
        Effect of dietary cis and trans-fatty acids on serum lipoprotein(a) levels in human.
        J Lipid Res. 1992; 33: 1493-1501
        • Nestel P
        • Noakes M
        • Belling B
        • McArthur R
        • Clifton P
        • Janus E
        • Abbey M
        Plasma lipoprotein lipid and Lp(a) changes with substitution of elaidic acid for oleic acid in the diet.
        J Lipid Res. 1992; 33: 1029-1036
        • Brousseau ME
        • Ordovas JM
        • Nicolosi RJ
        • Schaefer EJ
        Effects of dietary fat saturation on plasma lipoprotein(a) and hepatic apolipoprotein(a) mRNA concentrations in cynomolgus monkeys.
        Atherosclerosis. 1994; 106: 109-118
        • Beil FU
        • Terres W
        • Orgass M
        • Greten H
        Dietary fish oil lowers Lp(a) in primary hypertriglyceridemia.
        Atherosclerosis. 1991; 90: 95-97
        • Salvi A
        • Di Stefano O
        • Sleiman I
        • Spandrio S
        • Balesrieri GP
        • Scalvini T
        Effects of fish oil on serum lipids and lipoprotein(a) levels in heterozygous familial hypercholesterolemia.
        Curr Ther Res Clin Exp. 1993; 53: 717-721
        • Herrmann W
        • Biermann J
        • Lindhofer HG
        • Kostner GM
        Beeinflussung des atherogenen risikofaktors Lp(a) durch supplementa¨re fischo¨laufnahme bei patienten mit moderatem physischen training.
        Med Klin. 1989; 84: 429-433
        • Haglund O
        • Mehta JL
        • Saldeen T
        Effects of fish oil on some parameters of fibrinolysis and lipoprotein(a) in healthy subjects.
        Am J Cardiol. 1994; 74: 189-192
        • Berg-Schmidt E
        • Klausen IC
        • Kristensen SD
        • Levang HH
        • Faergeman O
        • Dyerberg J
        The effect of n-3 polyunsaturated fatty acids on Lp(a).
        Clin Chim Acta. 1991; 198: 271-278
        • Kostner GM
        • Avogaro P
        • Cazzolato G
        • Marth E
        • Bittolo Bon G
        Lipoprotein Lp(a) and the risk for myocardial infarction.
        Atherosclerosis. 1981; 38: 51-61
        • Vessby B
        • Kostner GM
        • Lithell H
        • Thomis J
        Divergent effects of cholestyramine on apolipoprotein Lp (a): a dose response study of the effects of cholestyramine in hypercholesterolemia.
        Atherosclerosis. 1982; 44: 61-71
        • Weber E
        Grundriss der biologischen statistik.
        in: Fischer Verlag, Jena1986: 172-179
        • Weber E
        Grundriss der biologischen statistik.
        in: Fischer Verlag, Jena1986: 215-219
        • Homstra G
        • VanHouwelingen AC
        • Kester ADM
        • Sundram K
        A palm oil enriched diet lowers serum lipoprotein(a) in normo-cholesterolemic volunteers.
        Atherosclerosis. 1991; 90: 91-93
        • Rainwater DL
        Genetic effects on dietary response of Lp(a) concentrations in baboons.
        Chem Phys Lipids. 1994; 67–68: 199-205
        • Iritani N
        • Inoguchi K
        • Endo M
        • Fukuda E
        • Morita M
        Identification of shellfish fatty acids and their effects on lipogenic enzymes.
        Biochim Biophys Acta. 1980; 618: 378-382
        • Wong SH
        • Fisher EA
        • Marsh JB
        Effects of eicosapentaenoic and docosahexaenoic acids on the apolipoprotein B mRNA and secretion of very low density lipoprotein in HepG2 cells.
        Arteriosclerosis. 1989; 9: 836-841
        • Crook D
        • Sidhu M
        • Seed M
        • O'Donell M
        • Stevenson JC
        Lipoprotein Lp(a) levels are reduced by danazolol, an anabolic steroid.
        Atherosclerosis. 1992; 92: 41-47
        • Kraft HG
        • Menzel H
        • Hoppichler F
        • Vogel W
        • Utermann G
        Changes of genetic apolipoprotein phenotypes caused by liver transplantation: implications for apolipoprotein synthesis.
        J Clin Invest. 1989; 83: 137-142
        • Koschinsky ML
        • Cote GP
        • Gabel B
        • Hoek YY
        Identification of the cysteine residue in apolipoprotein(a) that mediates extracellular coupling with apolipoprotein B-100.
        J Biol Chem. 1993; 268: 19819-19825
        • Frank SS
        • Klisak I
        • Sparkers RS
        The apolipoprotein(a) gene resides on human chromosome 6q26–27, in close proximity to the homologous gene for plasminogen.
        Hum Genet. 1988; 79: 352-356
        • Mehta J
        • Lawson D
        • Saldeen TJ
        Reduction in plasminogen activator inhibitor-1(PAI-1) with omega-3 polyunsaturated fatty acid (PUFA) intake.
        Am Heart J. 1988; 116: 1201-1206
        • Takimoto G
        • Galang J
        • Lee KG
        • Bradlow BA
        Plasma fibrinolytic activity after ingestion of omega-3 fatty acids in human subjects.
        Thromb Res. 1989; 54: 573-582