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Bayar E, Saso S, Galazis N, Jones B, Bracewell-Milnes T, Chawla M, Ahmed-Salim Y, Nagi JB. Impact of polyunsaturated fatty acid supplementation on assisted reproductive technology outcomes: a systematic review. HUM FERTIL 2023; 26:678-686. [PMID: 34906024 DOI: 10.1080/14647273.2021.2007421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 08/30/2021] [Indexed: 10/19/2022]
Abstract
This review explores the impact of polyunsaturated fatty acid (PUFA) supplementation in women undergoing assisted reproductive technology (ART) on reproductive outcomes. A systematic search of English peer-reviewed journals was carried out using MEDLINE, EMBASE, and the Cochrane Library to identify articles published from January 1978 to 2021. The primary outcomes assessed included pregnancy and live birth rates. Secondary outcome measures included: (i) implantation rate; (ii) fertilisation rate; (iii) number of oocytes retrieved; (iv) number of metaphase II (MII) oocytes; (v) blastocyst conversion; and (vi) embryo quality. A total of 4 randomised control trials (RCTs) met the inclusion criteria. There is a lack of high-quality research to support widespread dietary supplementation with PUFAs in women undergoing ART. Prior to its clinical recommendation, there is a need for well-designed RCTs to facilitate an in-depth understanding of PUFA supplementation in women undergoing ART.
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Affiliation(s)
- Erna Bayar
- Imperial College NHS Healthcare Trust, Queen Charlotte's Hospital, London, UK
- Institute for Reproductive Development and Biology, Imperial College London, London, UK
| | - Srdjan Saso
- Imperial College NHS Healthcare Trust, Queen Charlotte's Hospital, London, UK
- Institute for Reproductive Development and Biology, Imperial College London, London, UK
| | - Nicolas Galazis
- Obstetrics and Gynaecology Department, Northwick Park NHS Trust, London, UK
| | - Benjamin Jones
- Imperial College NHS Healthcare Trust, Queen Charlotte's Hospital, London, UK
- Institute for Reproductive Development and Biology, Imperial College London, London, UK
| | | | - Mehar Chawla
- Obstetrics & Gynaecology Department, North Middlesex University Hospital, London, UK
| | - Yousra Ahmed-Salim
- Institute for Reproductive Development and Biology, Imperial College London, London, UK
- Imperial College NHS Healthcare Trust, Charing Cross Hospital, London, UK
| | - Jara Ben Nagi
- The Centre for Reproductive and Genetic Health, London, UK
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Sereni A, Sticchi E, Gori AM, Magi A, Della Latta D, Volta A, Murri A, Jamagidze G, Chiappino D, Abbate R, Gensini GF, Marcucci R, Sofi F, Giusti B. Genetic and nutritional factors determining circulating levels of lipoprotein(a): results of the "Montignoso Study". Intern Emerg Med 2020; 15:1239-1245. [PMID: 31993950 DOI: 10.1007/s11739-020-02276-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 01/10/2020] [Indexed: 01/02/2023]
Abstract
Increasing evidence shows an association between high lipoprotein(a) [Lp(a)] levels and atherothrombotic diseases. Lp(a) trait is largely controlled by kringle-IV type 2 (KIV-2) size polymorphism in LPA gene, encoding for apo(a). Environmental factors are considered to determinate minor phenotypic variability in Lp(a) levels. In the present study, we investigated the possible gene-environment interaction between KIV-2 polymorphism and Mediterranean diet adherence or fish weekly intake in determining Lp(a) levels. We evaluated Lp(a), KIV-2 polymorphism, fish intake and Mediterranean diet adherence in 452 subjects [median age (range) 66 (46-80)years] from Montignoso Heart and Lung Project (MEHLP) population. In subjects with high KIV-2 repeats number, influence of Mediterranean diet adherence in reducing Lp(a) levels was observed (p = 0.049). No significant difference in subjects with low KIV-2 repeats according to diet was found. Moreover, in high-KIV-2-repeat subjects, we observed a trend towards influence of fish intake on reducing Lp(a) levels (p = 0.186). At multivariate linear regression analysis, high adherence to Mediterranean diet remains a significant and independent determinant of lower Lp(a) levels (β = - 64.97, standard error = 26.55, p = 0.015). In conclusion, this study showed that only subjects with high KIV-2 repeats can take advantage to lower Lp(a) levels from correct nutritional habits and, in particular, from Mediterranean diet.
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Affiliation(s)
- Alice Sereni
- Department of Experimental and Clinical Medicine, University of Florence, Atherothrombotic Diseases Center, Careggi Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Elena Sticchi
- Department of Experimental and Clinical Medicine, University of Florence, Atherothrombotic Diseases Center, Careggi Hospital, Largo Brambilla 3, 50134, Florence, Italy.
| | - Anna Maria Gori
- Department of Experimental and Clinical Medicine, University of Florence, Atherothrombotic Diseases Center, Careggi Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Alberto Magi
- Department of Experimental and Clinical Medicine, University of Florence, Atherothrombotic Diseases Center, Careggi Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | | | - Andrea Volta
- Department of Experimental and Clinical Medicine, University of Florence, Atherothrombotic Diseases Center, Careggi Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Alessandra Murri
- Department of Experimental and Clinical Medicine, University of Florence, Atherothrombotic Diseases Center, Careggi Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Giuli Jamagidze
- Gabriele Monasterio Foundation, Regione Toscana CNR, Pisa, Italy
| | - Dante Chiappino
- Gabriele Monasterio Foundation, Regione Toscana CNR, Pisa, Italy
| | - Rosanna Abbate
- Department of Experimental and Clinical Medicine, University of Florence, Atherothrombotic Diseases Center, Careggi Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Gian Franco Gensini
- Department of Experimental and Clinical Medicine, University of Florence, Atherothrombotic Diseases Center, Careggi Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Rossella Marcucci
- Department of Experimental and Clinical Medicine, University of Florence, Atherothrombotic Diseases Center, Careggi Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Francesco Sofi
- Department of Experimental and Clinical Medicine, University of Florence, Unit of Clinical Nutrition, Careggi Hospital, Florence, Italy
| | - Betti Giusti
- Department of Experimental and Clinical Medicine, University of Florence, Atherothrombotic Diseases Center, Careggi Hospital, Largo Brambilla 3, 50134, Florence, Italy
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Potential Cardiovascular and Metabolic Beneficial Effects of ω-3 PUFA in Male Obesity Secondary Hypogonadism Syndrome. Nutrients 2020; 12:nu12092519. [PMID: 32825328 PMCID: PMC7551945 DOI: 10.3390/nu12092519] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/10/2020] [Accepted: 08/17/2020] [Indexed: 02/06/2023] Open
Abstract
Long-chain ω-3 polyunsaturated fatty acids (PUFAs) are fundamental biocomponents of lipids and cell membranes. They are involved in the maintenance of cellular homeostasis and they are able to exert anti-inflammatory and cardioprotective actions. Thanks to their potential beneficial effects on the cardiovascular system, metabolic axis and body composition, we have examined their action in subjects affected by male obesity secondary hypogonadism (MOSH) syndrome. MOSH syndrome is characterized by the presence of obesity associated with the alteration of sexual and metabolic functions. Therefore, this review article aims to analyze scientific literature regarding the possible benefits of ω-3 PUFA administration in subjects affected by MOSH syndrome. We conclude that there are strong evidences supporting ω-3 PUFA administration and/or supplementation for the treatment and management of MOSH patients.
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Sakamoto A, Saotome M, Iguchi K, Maekawa Y. Marine-Derived Omega-3 Polyunsaturated Fatty Acids and Heart Failure: Current Understanding for Basic to Clinical Relevance. Int J Mol Sci 2019; 20:ijms20164025. [PMID: 31426560 PMCID: PMC6719114 DOI: 10.3390/ijms20164025] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/15/2019] [Accepted: 08/16/2019] [Indexed: 12/13/2022] Open
Abstract
Heart failure (HF) is a rapidly growing global public health problem. Since HF results in high mortality and re-hospitalization, new effective treatments are desired. Although it remains controversial, omega 3 polyunsaturated fatty acids (n-3 PUFAs), such as the eicosapentaenoic acid and docosahexaenoic acid, have been widely recognized to have benefits for HF. In a large-scale clinical trial regarding secondary prevention of HF by n-3 PUFA (GISSI-HF trial), the supplementation of n-3 PUFA significantly reduced cardiovascular mortality and hospitalization. Other small clinical studies proposed that n-3 PUFA potentially suppresses the ventricular remodeling and myocardial fibrosis, which thereby improves the ventricular systolic and diastolic function both in ischemic and non-ischemic HF. Basic investigations have further supported our understanding regarding the cardioprotective mechanisms of n-3 PUFA against HF. In these reports, n-3 PUFA has protected hearts through (1) anti-inflammatory effects, (2) intervention of cardiac energy metabolism, (3) modification of cardiac ion channels, (4) improvement of vascular endothelial response, and (5) modulation of autonomic nervous system activity. To clarify the pros and cons of n-3 PUFA on HF, we summarized recent evidence regarding the beneficial effects of n-3 PUFA on HF both from the clinical and basic studies.
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Affiliation(s)
- Atsushi Sakamoto
- Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan
| | - Masao Saotome
- Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan.
| | - Keisuke Iguchi
- Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan
| | - Yuichiro Maekawa
- Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan
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Goel A, Pothineni NV, Singhal M, Paydak H, Saldeen T, Mehta JL. Fish, Fish Oils and Cardioprotection: Promise or Fish Tale? Int J Mol Sci 2018; 19:E3703. [PMID: 30469489 PMCID: PMC6321588 DOI: 10.3390/ijms19123703] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 11/19/2018] [Accepted: 11/20/2018] [Indexed: 12/17/2022] Open
Abstract
Fish and commercially available fish oil preparations are rich sources of long-chain omega-3 polyunsaturated fatty acids. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are the most important fatty acids in fish oil. Following dietary intake, these fatty acids get incorporated into the cell membrane phospholipids throughout the body, especially in the heart and brain. They play an important role in early brain development during infancy, and have also been shown to be of benefit in dementia, depression, and other neuropsychiatric disorders. Early epidemiologic studies show an inverse relationship between fish consumption and the risk of coronary heart disease. This led to the identification of the cardioprotective role of these marine-derived fatty acids. Many experimental studies and some clinical trials have documented the benefits of fish oil supplementation in decreasing the incidence and progression of atherosclerosis, myocardial infarction, heart failure, arrhythmias, and stroke. Possible mechanisms include reduction in triglycerides, alteration in membrane fluidity, modulation of cardiac ion channels, and anti-inflammatory, anti-thrombotic, and anti-arrhythmic effects. Fish oil supplements are generally safe, and the risk of toxicity with methylmercury, an environmental toxin found in fish, is minimal. Current guidelines recommend the consumption of either one to two servings of oily fish per week or daily fish oil supplements (around 1 g of omega-3 polyunsaturated fatty acids per day) in adults. However, recent large-scale studies have failed to demonstrate any benefit of fish oil supplements on cardiovascular outcomes and mortality. Here, we review the different trials that evaluated the role of fish oil in cardiovascular diseases.
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Affiliation(s)
- Akshay Goel
- Division of Cardiology, University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System, Little Rock, AR 72205, USA.
| | - Naga Venkata Pothineni
- Division of Cardiology, University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System, Little Rock, AR 72205, USA.
| | | | - Hakan Paydak
- Division of Cardiology, University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System, Little Rock, AR 72205, USA.
| | - Tom Saldeen
- Division of Cardiology, University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System, Little Rock, AR 72205, USA.
| | - Jawahar L Mehta
- Division of Cardiology, University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System, Little Rock, AR 72205, USA.
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6
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Adkins Y, Kelley DS. Mechanisms underlying the cardioprotective effects of omega-3 polyunsaturated fatty acids. J Nutr Biochem 2010; 21:781-92. [DOI: 10.1016/j.jnutbio.2009.12.004] [Citation(s) in RCA: 362] [Impact Index Per Article: 25.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Revised: 12/01/2009] [Accepted: 12/03/2009] [Indexed: 12/11/2022]
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The Effects of Extended Release Niacin in Combination with Omega 3 Fatty Acid Supplements in the Treatment of Elevated Lipoprotein (a). CHOLESTEROL 2010; 2010:306147. [PMID: 21490914 PMCID: PMC3065818 DOI: 10.1155/2010/306147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2009] [Revised: 12/18/2009] [Accepted: 12/22/2009] [Indexed: 11/18/2022]
Abstract
Objective. To assess the effectiveness of niacin/fish oil combination therapy in reducing Lipoprotein (a) [Lp(a)] levels after twelve weeks of therapy.
Background. Lipoprotein (a) accumulates in atherosclerotic lesions and promotes smooth muscle cell growth and is both atherogenic and thrombogenic. A clinical trials of combination therapy for the reduction of Lp(a) has not been previously reported.
Methods. The study was an observational study following subjects with an elevated Lp(a) (>70 nmol/L) to assess impact of 12 weeks of combination Omega 3FA, niacin, and the Mediterranean diet on Lp(a).
Results. Twenty three patients were enrolled with 7 patients lost to follow up and 2 patients stopped due to adverse events. The average Lp(a) reduction in the remaining 14 subjects after 12 weeks of combination therapy was 23% ± 17% [P = .003] with a significant association of the reduction of Lp(a) with increasing baseline levels of Lp(a) [R2 = 0.633, P = .001].
Conclusions. There was a significant reduction in Lp(a) levels with combination therapy. A more pronounced effect was noted in patients with higher baseline levels of Lp(a).
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Beavers KM, Beavers DP, Bowden RG, Wilson RL, Gentile M. Effect of Over-the-Counter Fish-Oil Administration on Plasma Lp(a) Levels in an End-Stage Renal Disease Population. J Ren Nutr 2009; 19:443-9. [DOI: 10.1053/j.jrn.2009.06.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2009] [Indexed: 11/11/2022] Open
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10
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Sofi F, Fatini C, Sticchi E, Lenti M, Gori AM, Giusti B, Fedi S, Casini A, Abbate R, Gensini GF. Fish intake and LPA 93C>T polymorphism: gene-environment interaction in modulating lipoprotein (a) concentrations. Atherosclerosis 2007; 195:e147-54. [PMID: 17603063 DOI: 10.1016/j.atherosclerosis.2007.05.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2007] [Revised: 05/18/2007] [Accepted: 05/22/2007] [Indexed: 11/17/2022]
Abstract
High plasma lipoprotein (a) [Lp(a)] concentrations are an independent risk factor for atherosclerotic diseases. To date, no effective intervention strategies on reducing Lp(a) concentrations have been reported. The aim of the study was to evaluate the possible modulation of two polymorphisms of LPA gene (LPA 93C>T and LPA 121G>A) and nutritional habits on Lp(a) concentrations. We studied 647 healthy Italian subjects (260 M; 387 F) with a median age of 48 years (range: 19-78) enrolled in an epidemiological study conducted in Florence, Italy. A linear regression analysis showed a significant negative influence of fish intake (beta=-0.174+/-0.084; p=0.04) on Lp(a) concentrations, after adjustment for smoking habit, C-reactive protein serum concentrations, dietary habits and LDL-cholesterol concentrations. With regard to LPA polymorphisms, LPA 93C>T polymorphism resulted to significantly affect Lp(a) circulating concentrations in a dose-dependent manner, with lower concentrations shown by subjects carrying the T rare allele, whereas no significant influence of LPA 121G>A polymorphism on Lp(a) concentrations was observed. Moreover, by analyzing the possible interplay between LPA 93C>T and dietary fish intake, a significant interaction between these two determinants in lowering Lp(a) concentrations was reported. In addition, lower Lp(a) concentrations were observed in subjects carrying the T allele of the LPA 93C>T polymorphism and consuming a high intake of fish with respect to those being in the highest tertile of fish consumption but homozygotes for the common allele of the polymorphism. In conclusion, this study reported a significant interaction of daily fish intake and LPA 93C>T polymorphism in decreasing Lp(a) concentrations.
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Affiliation(s)
- Francesco Sofi
- Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Italy.
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11
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Carrero JJ, Baró L, Fonollá J, González-Santiago M, Martínez-Férez A, Castillo R, Jiménez J, Boza JJ, López-Huertas E. Cardiovascular effects of milk enriched with ω-3 polyunsaturated fatty acids, oleic acid, folic acid, and vitamins E and B6 in volunteers with mild hyperlipidemia. Nutrition 2004; 20:521-7. [PMID: 15165614 DOI: 10.1016/j.nut.2004.03.017] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Results from epidemiologic studies and clinical trials have indicated that consumption of omega-3 fatty acids, oleic acid, and folic acid have beneficial effects on health, including decreased risk of cardiovascular disease. We evaluated the combined effects of these nutrients through the consumption of milk enriched with omega-3 polyunsaturated fatty acids, oleic acid, vitamins E and B6, and folic acid on risk factors for cardiovascular disease in volunteers with mild hyperlipidemia. METHODS Thirty subjects ages 45 to 65 y (51.3 +/- 5.3 y) were given 500 mL/d of semi-skimmed milk for 4 wk and then 500 mL/d of the enriched milk for 8 wk. Plasma and low-density lipoproteins were obtained at the beginning of the study and at 4, 8, and 12 wk. RESULTS Consumption of enriched milk for 8 wk increased plasma concentrations of docosahexaenoic acid and eicosapentaenoic acid and significantly (P < 0.05) decreased plasma concentrations of triacylglycerol (24%), total cholesterol (9%), and low-density lipoprotein cholesterol (13%). Plasma and low-density lipoprotein oxidation and vitamin E concentration remained unchanged throughout the study. Significant decreases in plasma concentrations of vascular cell adhesion molecule-1 (9%) and homocysteine (17%) were found, accompanied by a 98% increase in plasma concentration of folic acid. CONCLUSIONS Dairy supplementation strategies with omega-3 polyunsaturated fatty acids, oleic acid, and vitamins may be useful for decreasing risk factors for cardiovascular disease.
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Abstract
Endothelial cells produce vasodilator and vasoconstrictor substances. Dietary factors such as sodium, potassium, calcium, magnesium, zinc, selenium, vitamins A, C, and E, and essential fatty acids and their products such as eicosanoids can influence blood pressure, cardio- and cerebrovascular diseases, and concentrations of blood lipids and atherosclerosis. There might be a close interaction between these dietary factors, sympathetic and parasympathetic nervous systems, the metabolism of essential fatty acids, nitric oxide, prostacyclin, and endothelium in human essential hypertension. A deficiency in any one factor, dietary or endogenous, or alterations in their interactions with each other, can lead to endothelial dysfunction and development of hypertension. Therefore, alterations in the metabolism of essential fatty acids might be a predisposing factor to the development of essential hypertension and insulin resistance.
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Affiliation(s)
- U N Das
- EFA Sciences LLC, Norwood, Massachusetts 02062, USA.
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Inoue T, Uchida T, Kamishirado H, Takayanagi K, Morooka S. Antibody against oxidized low density lipoprotein may predict progression or regression of atherosclerotic coronary artery disease. J Am Coll Cardiol 2001; 37:1871-6. [PMID: 11401125 DOI: 10.1016/s0735-1097(01)01228-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVES This study aimed to elucidate whether an antibody against oxidized low density lipoprotein (anti-Ox-LDL) could predict short-term coronary artery atherosclerotic lesion progression. BACKGROUND It is still controversial whether higher levels of the anti-Ox-LDL titer are associated with atherosclerotic coronary artery disease. METHODS In 52 patients undergoing coronary angioplasty and six-month follow-up angiography, we performed quantitative coronary angiographic analysis of a lesion on a branch away from the intervention site vessel and assessed lesion progression or regression using the Progression-Regression score calculated as the baseline minimal lumen diameter minus the follow-up minimal lumen diameter. The serum anti-Ox-LDL titer was measured using an enzyme-linked immunosorbent assay method just before the initial angiography in all patients. RESULTS The anti-Ox-LDL titer was 16.6+/-1.5 AcU/ml in the progression group (Progression-Regression score >0.15 mm; n = 20), which was significantly higher (p < 0.001) than the value of 9.5+/-1.2 in the regression group (< or =-0.15 mm; n = 14) and also higher (p < 0.01) than the value of 11.4+/-1.3 in the no-change group (-0.15 to 0.15 mm; n = 18). The Progression-Regression score was correlated with the antibody titer in all patients (r = 0.56, p < 0.001). Multiple regression analysis showed that the Progression-Regression score was independently correlated with the antibody titer (r = 0.44, p < 0.01) as well as lipoprotein (a) (r = 0.33, p < 0.05). CONCLUSIONS Anti-Ox-LDL may be an independent predictor of coronary atherosclerotic lesion progression in the short term.
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Affiliation(s)
- T Inoue
- Department of Cardiology, Koshigaya Hospital, Dokkyo University School of Medicine, Saitama, Japan.
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14
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Abstract
n-3 Polyunsaturated fatty acids, mainly those contained in fish oils, are candidates for inclusion in secondary prevention programmes for coronary heart disease, based on the results of recent randomized trials in humans. Marine n-3 polyunsaturated fatty acids retard coronary atherosclerosis and appear to prevent fatal arrhythmias; and they decrease mortality subsequent to myocardial infarction.
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Affiliation(s)
- P Angerer
- Medizinische Klinik Innenstadt, Klinikum der Ludwig-Maximilians-Universität München, Munich, Germany.
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15
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Allen JD, Wilson JB, Tulley RT, Lefevre M, Welsch MA. Influence of age and normal plasma fibrinogen levels on flow-mediated dilation in healthy adults. Am J Cardiol 2000; 86:703-5, A9. [PMID: 10980232 DOI: 10.1016/s0002-9149(00)01060-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study examined the effects of age-associated increases in fibrinogen on brachial artery flow-mediated dilation in 30 healthy nonsmokers. The findings demonstrate an inverse association between normal plasma fibrinogen levels and vascular function (r = -0.56, p = 0.001), suggesting elevated plasma fibrinogen may decrease the artery's responsiveness to certain vasodilatory signals, such as shear stress.
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Affiliation(s)
- J D Allen
- Department of Kinesiology and Pennington Biomedical Research Center, Louisiana State University, Baton Rouge 70803, USA
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16
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Hansen J, Grimsgaard S, Nordoy A, Bonaa KH. Dietary supplementation with highly purified eicosapentaenoic acid and docosahexaenoic acid does not influence PAI-1 activity. Thromb Res 2000; 98:123-32. [PMID: 10713313 DOI: 10.1016/s0049-3848(99)00223-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Impaired fibrinolysis due to elevated levels of plasminogen activator inhibitor type 1 (PAI-1) is a risk factor for atherothrombotic disease. Many studies have reported a positive correlation between serum triglycerides and PAI-1 activity. Dietary intervention with very long n-3 fatty acids from marine sources is known to decrease serum triglycerides, but an adverse increase in PAI-1 activity has been reported in some studies. A double blind, placebo controlled study was conducted among 224 middle-aged (ages 36-56), healthy, non-smoking men in which the participants were randomly assigned to daily supplementation with 3.8 g eicosapentaenoic acid/d, 3.6 g docosahexaenoic acid/d, or 4.0 g corn oil/d (placebo) for 7 weeks. PAI-1 activity increased by 2.35+/-6.24 U/ml (28%), 1.15+/-6.74 U/ml (14%), and 1.33+/-5.64 U/ml (22%) during dietary supplementation with eicosapentaenoic acid, docosahexaenoic acid, and corn oil, respectively, but the changes were not significantly different between groups. There was no relationship between change in concentrations of serum triglycerides or phospholipid n-3 fatty acids and change in PAI-1 activity. At baseline, analysis was performed to investigate the influence of dietary lipids, blood lipids, and serum fatty acids on plasma concentrations of PAI-1 activity. Dietary intake of saturated fat correlated directly with PAI-1 both in crude analysis and after adjustment for age and body mass index (kg/m(2)). Furthermore, PAI-1 was associated with body mass index, apo-B100, serum triglycerides, and the concentration of n-6 polyunsaturated fatty acids in serum. In a multiple regression analysis, 21% of the variation in PAI-1 activity could be explained by these variables. Plasma PAI-1 activity did not correlate with dietary intake or serum concentrations of n-3 polyunsaturated fatty acids. In a review of 17 trials, including 935 subjects that assessed the effect of n-3 fatty acids on PAI-1 activity, an overall 17.7% increase in PAI-1 activity was estimated by n-3 supplementation. However, only two studies were able to demonstrate a significant increase in PAI-1 attributable to n-3 fatty acid supplementation. We conclude that there is no strong evidence for an unfavourable, clinically relevant effect of n-3 fatty acids on PAI-1 activity in plasma.
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Affiliation(s)
- J Hansen
- Department of Medicine, Institute of Clinical Medicine, University of Tromso, N-9037, Tromso, Norway.
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17
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Abstract
n-3 Polyunsaturated fatty acids, mainly those contained in fish oils, are candidates for inclusion in secondary prevention programmes for coronary heart disease, based on the results of recent randomized trials in humans. Marine n-3 polyunsaturated fatty acids retard coronary atherosclerosis and appear to prevent fatal arrhythmias; and they decrease mortality subsequent to myocardial infarction.
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Affiliation(s)
- P Angerer
- Medizinische Klinik Innenstadt, Klinikum der Ludwig-Maximilians-Universität München, Munich, Germany.
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Marcovina SM, Kennedy H, Bittolo Bon G, Cazzolato G, Galli C, Casiglia E, Puato M, Pauletto P. Fish intake, independent of apo(a) size, accounts for lower plasma lipoprotein(a) levels in Bantu fishermen of Tanzania: The Lugalawa Study. Arterioscler Thromb Vasc Biol 1999; 19:1250-6. [PMID: 10323776 DOI: 10.1161/01.atv.19.5.1250] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Plasma lipoprotein(a) [Lp(a)] levels are largely genetically determined by sequences linked to the gene encoding apolipoprotein(a) [apo(a)], the distinct protein component of Lp(a). Apo(a) is highly polymorphic in length due to variation in the numbers of a sequence encoding the apo(a) kringle 4 domain, and plasma levels of Lp(a) are inversely correlated with apo(a) size. In 2 racially homogeneous Bantu populations from Tanzania differing in their dietary habits, we found that median plasma levels of Lp(a) were 48% lower in those living on a fish diet than in those living on a vegetarian diet. Considering the relationship between apo(a) size and Lp(a) plasma concentration, we have extensively evaluated apo(a) isoform distribution in the 2 populations to determine the impact of apo(a) size in the determination of Lp(a) values. The majority of individuals (82% of the fishermen and 80% of the vegetarians) had 2 expressed apo(a) alleles. Additionally, the fishermen had a high frequency of large apo(a) isoforms, whereas a higher frequency of small isoforms was found in the vegetarians. When subjects from the 2 groups were matched for apo(a) phenotype, the median Lp(a) value was 40% lower in Bantus on the fish diet than in those on the vegetarian diet. A significant inverse relationship was also found between plasma n-3 polyunsaturated fatty acids and Lp(a) levels (r=-0.24, P=0.01). The results of this study are consistent with the concept that a diet rich in n-3 polyunsaturated fatty acids, and not genetic differences, is responsible for the lower plasma levels of Lp(a) in the fish-eating Bantus and strongly suggest that a sustained fish-based diet is able to lower plasma levels of Lp(a).
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Affiliation(s)
- S M Marcovina
- Department of Medicine, University of Washington, Seattle, USA
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Haglund O, Wallin R, Wretling S, Hultberg B, Saldeen T. Effects of fish oil alone and combined with long chain (n-6) fatty acids on some coronary risk factors in male subjects. J Nutr Biochem 1998. [DOI: 10.1016/s0955-2863(98)00065-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
Lp(a) concentrations are controlled primarily by genetic variation at LPA, the locus encoding the unique protein apo(a). However, the high heritability is in part a consequence of nearly a 1000-fold range of Lp(a) concentrations found in healthy individuals. As determined by use of siblings genetically identical-by-descent at the LPA locus, there is substantial within-genotype variation in Lp(a) concentrations (ranges averaged about 58% of mean values for 87 sibling groups). This within-genotype variation could affect risk of CVD for nearly 15% of individuals in a population. Furthermore, Lp(a) concentrations are significantly and independently correlated with two key indicators of lipoprotein metabolism, plasma cholesterol and triglyceride concentrations. Taken together, these data suggest that it is both possible and desirable to develop strategies for modifying Lp(a) concentrations.
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Affiliation(s)
- D L Rainwater
- Department of Genetics, Southwest Foundation for Biomedical Research, San Antonio, TX 78245-0549, USA.
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Pauletto P, Puato M, Caroli MG, Casiglia E, Munhambo AE, Cazzolato G, Bittolo Bon G, Angeli MT, Galli C, Pessina AC. Blood pressure and atherogenic lipoprotein profiles of fish-diet and vegetarian villagers in Tanzania: the Lugalawa study. Lancet 1996; 348:784-8. [PMID: 8813985 DOI: 10.1016/s0140-6736(96)01391-8] [Citation(s) in RCA: 92] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND There is evidence that populations with a high intake of fish, and specifically fish oils, are at reduced risk of cardiovascular disease. To explore the effect of fish intake, we compared two groups of Bantu villagers in Tanzania; one group live on the shores of Lake Nyasa and their diet includes large amounts of freshwater fish; the other group live in the nearby hills and have a vegetarian diet. METHODS We carried out a cross-sectional study of 622 fish-consuming villagers and 686 vegetarian villagers. 618 (99.4%) and 645 (94.0%), respectively, agreed to take part. Anthropometric and self-reported medical history data were collected by one local physician and a medical assistant, who also measured blood pressure and took blood samples for measurement of plasma lipids. A dietary questionnaire was administered to 25 families (about 15% of the study population) in each village. FINDINGS After adjustment for age, sex, and alcohol intake the fish-consuming group had lower mean blood pressure than the vegetarian group (123/72 vs 133/76 mm Hg, p < 0.001). The frequencies of definite and borderline hypertension (by WHO criteria) were lower in the fish-consuming than in the vegetarian group (2.8 vs 16.4%; 9.7 vs 22.3%, respectively). Plasma concentrations of total cholesterol (mean 3.53 [SD 1.04] vs 4.10 [1.04] mmol/L), triglycerides (0.92 [0.64] vs 1.31 [0.64] mmol/L), and lipoprotein(a) (201 [213] vs 321 [212] mg/L), were all lower (p < 0.0001) in the fish-consuming group than in the vegetarian group. The proportions of n-3 polyunsaturated fatty acids in plasma lipids were higher (p < 0.0001) in the fish-consuming group than in the vegetarian group (eicosapentaenoic acid 2.3 [1.3] vs 0.7 [0.2]%; docosapentaenoic acid 1.1 [0.4] vs 0.6 [0.3]%; docosahexaenoic acid 5.7 [1.6] vs 1.5 [1.1]%). INTERPRETATION In these villagers, consumption of freshwater fish (300-600 g daily) was associated with raised plasma concentrations of n-3 polyunsaturated fatty acids, lower blood pressure, and lower plasma lipid concentrations.
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Affiliation(s)
- P Pauletto
- Dipartimento di Medicina Clinica e Sperimentale, Università di Padova, Italy
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Pauletto P, Puato M, Angeli MT, Pessina AC, Munhambo A, Bittolo-Bon G, Galli C. Blood pressure, serum lipids, and fatty acids in populations on a lake-fish diet or on a vegetarian diet in Tanzania. Lipids 1996; 31 Suppl:S309-12. [PMID: 8729141 DOI: 10.1007/bf02637098] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Major risk factors for coronary heart disease were assessed in two populations of Tanzania, one on a fish diet (FD) living along the coast of Lake Nyasa, and the other, mainly on a vegetarian diet (VD), living in a farming area. Lower blood pressure values were found in the FD subjects (n = 618) vs. VD (n = 618) (systolic blood pressure, SBP, 120 +/- 15 vs. 135 +/- 20, P < 0.01; diastolic blood pressure, DBP, 70 +/- 9 vs. 78 +/- 11, P < 0.01, respectively). In an FD subgroup (n = 61), total cholesterol (TC) (122 vs. 136 mg/dL, P < 0.01); triglycerides (TG) (82 vs. 105 mg/dL, P < 0.01); and lipoprotein (a) [Lp(a)] (19.9 +/- 18.4 vs. 32.3 +/- 22.4, P < 0.001) were lower than in a VD subgroup (n = 55). Serum fatty acids (FA) in the FD subgroup were as follows: eicosapentaenoic acid (EPA) (20:5) 2.48 vs. 0.72%, docosahexaenoic acid (DHA) (22:6) 5.93 vs. 1.49%, vs. the VD, respectively. Arachidonic acid (AA) (20:4n-6) also was higher in the FD vs. the VD group (9.85 vs. 8.30%, P < 0.05), whereas 18:2n-6 was about double (23.97 and 14.85%) in VD vs. FD. The peculiar serum FA pattern in FD reflected the FA of dietary fish. In fact, in four main species of lake fish, DHA was 8-19%, higher than EPA (1.8-4.2%), in contrast with the situation in cold-water fish, and AA was 5.8-8%, higher than in cold-water fish. The data, obtained in populations strictly on natural, unprocessed, low-fat diets, show that a diet based on freshwater fish results in lower BP, serum TC, TG, and Lp(a), and suggests that serum AA is not reduced when the major dietary n-3 is DNA rather than EPA.
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Affiliation(s)
- P Pauletto
- Institute of Clinical Medicine, University of Padua, Italy
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Herrmann W, Biermann J, Kostner GM. Comparison of effects of N-3 to N-6 fatty acids on serum level of lipoprotein(a) in patients with coronary artery disease. Am J Cardiol 1995; 76:459-62. [PMID: 7653444 DOI: 10.1016/s0002-9149(99)80130-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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 (approximately 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).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- W Herrmann
- Institut für Klinische Chemie und Laboratoriumsmedizin, Universität Regensburg, Germany
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Luostarinen R, Wallin R, Wibell L, Saldeen T. Vitamin E supplementation counteracts the fish oil-induced increase of blood glucose in humans. Nutr Res 1995. [DOI: 10.1016/0271-5317(95)00057-p] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Glueck CJ, Tracy T, Sieve-Smith L, Wang P. Whether, to what degree, and why lipoprotein(a) levels change over time. Clin Chim Acta 1995; 238:11-9. [PMID: 7554292 DOI: 10.1016/0009-8981(95)06070-t] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Our specific aim in this study of 6 +/- 2 serial lipoprotein(a) (Lp(a)) measurements over 1.7 +/- 0.5 years in 145 patients (64 men, 81 women, 135 whites, 10 blacks, mean age 63 years) with high Lp(a) (> or = 25 mg/dl) was to assess whether, to what degree, and why Lp(a) levels change over time. A second specific aim was to study the biological coefficient of variation of Lp(a) (C.V.b). No Lp(a) lowering drugs were given. In the 145 patients, mean (S.D.) and median Lp(a) on entry (70 +/- 34 and 59 mg/dl) did not differ from levels on follow-up (72 +/- 34 and 64 mg/dl) (P > 0.4). Mean (S.D.) C.V.b was 18 +/- 9%, median 17%, minimum 1.7% and maximum 58%. Three or four samples for Lp(a) measurement should be very adequate to establish a 'true' Lp(a) value, since C.V.bs based on three to four samples did not differ (P > 0.1) from those based on five to six, seven, eight, or nine samples. For patients with mean +/- S.D. baseline Lp(a) levels of 39 +/- 3, 49 +/- 3 and 59 +/- 2, 95% of the follow-up values fell in the following ranges: 25-78, 24-93 and 34-104 mg/dl. Lp(a) on study entry was highly correlated with Lp(a) on follow-up (r = 0.84, P = 0.0001) and with Lp(a)'s C.V.b on follow-up (r = 0.24, P = 0.003). Entry Lp(a) was inversely correlated with absolute and percent change in Lp(a) on follow-up (r = -0.38, P = 0.0001 for both).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- C J Glueck
- Cholesterol Center, Jewish Hospital, Cincinnati, OH 45229, USA
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