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Borja MS, Hammerson B, Tang C, Juarez-Serrano L, Savinova OV, Harris WS, Oda MN, Shearer GC. Effects of niacin and omega-3 fatty acids on HDL-apolipoprotein A-I exchange in subjects with metabolic syndrome. PLoS One 2024; 19:e0296052. [PMID: 38408107 PMCID: PMC10896500 DOI: 10.1371/journal.pone.0296052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 11/29/2023] [Indexed: 02/28/2024] Open
Abstract
HDL-apolipoprotein A-I exchange (HAE) measures a functional property associated with HDL's ability to mediate reverse cholesterol transport. HAE has been used to examine HDL function in case-control studies but not in studies of therapeutics that alter HDL particle composition. This study investigates whether niacin and omega-3 fatty acids induce measurable changes in HAE using a cohort of fifty-six subjects with metabolic syndrome (MetS) who were previously recruited to a double-blind trial where they were randomized to 16 weeks of treatment with dual placebo, extended-release niacin (ERN, 2g/day), prescription omega-3 ethyl esters (P-OM3, 4g/day), or the combination. HAE was assessed at the beginning and end of the study. Compared to placebo, ERN and P-OM3 alone significantly increased HAE by 15.1% [8.2, 22.0] (P<0.0001) and 11.1% [4.5, 17.7] (P<0.0005), respectively, while in combination they increased HAE by 10.0% [2.5, 15.8] (P = 0.005). When HAE was evaluated per unit mass of apoA-I ERN increased apoA-I specific exchange activity by 20% (2, 41 CI, P = 0.02) and P-OM3 by 28% (9.6, 48 CI, P<0.0006). However the combination had no statistically significant effect, 10% (-9, 31 CI, P = 0.39). With regard to P-OM3 therapy in particular, the HAE assay detected an increase in this property in the absence of a concomitant rise in HDL-C and apoA-I levels, suggesting that the assay can detect functional changes in HDL that occur in the absence of traditional biomarkers.
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Affiliation(s)
- Mark S. Borja
- Children’s Hospital Oakland Research Institute, Oakland, California, United States of America
- Department of Chemistry and Biochemistry, California State University East Bay, Hayward, California, United States of America
| | - Bradley Hammerson
- Children’s Hospital Oakland Research Institute, Oakland, California, United States of America
| | - Chongren Tang
- University of Washington School of Medicine, Seattle, Washington, United States of America
| | - Litzy Juarez-Serrano
- Department of Chemistry and Biochemistry, California State University East Bay, Hayward, California, United States of America
| | - Olga V. Savinova
- Cardiovascular Research Center, Sanford Research, University of South Dakota, Sioux Falls, South Dakota, United States of America
| | - William S. Harris
- Cardiovascular Research Center, Sanford Research, University of South Dakota, Sioux Falls, South Dakota, United States of America
- OmegaQuant, Sioux Falls, South Dakota, United States of America
| | - Michael N. Oda
- Children’s Hospital Oakland Research Institute, Oakland, California, United States of America
| | - Gregory C. Shearer
- Cardiovascular Research Center, Sanford Research, University of South Dakota, Sioux Falls, South Dakota, United States of America
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Zhong O, Wang J, Tan Y, Lei X, Tang Z. Effects of NAD+ precursor supplementation on glucose and lipid metabolism in humans: a meta-analysis. Nutr Metab (Lond) 2022; 19:20. [PMID: 35303905 PMCID: PMC8932245 DOI: 10.1186/s12986-022-00653-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This meta-analysis was performed to investigate the effects of nicotinamide adenine dinucleotide (NAD+) precursor supplementation on glucose and lipid metabolism in human body. METHODS PubMed, Embase, CENTRAL, Web of Science, Scopus databases were searched to collect clinical studies related to the supplement of NAD+ precursor from inception to February 2021. Then the retrieved documents were screened, the content of the documents that met the requirements was extracted. Meta-analysis and quality evaluation was performed detection were performed using RevMan5.4 software. Stata16 software was used to detect publication bias, Egger and Begg methods were mainly used. The main research terms of NAD+ precursors were Nicotinamide Riboside (NR), Nicotinamide Mononucleotide (NMN), Nicotinic Acid (NA), Nicotinamide (NAM). The changes in the levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and fasting blood glucose were mainly concerned. RESULTS A total of 40 articles were included in the meta-analysis, with a sample of 14,750 cases, including 7406 cases in the drug group and 7344 cases in the control group. The results of meta-analysis showed that: NAD+ precursor can significantly reduce TG level (SMD = - 0.35, 95% CI (- 0.52, - 0.18), P < 0.0001), and TC (SMD = - 0.33, 95% CI (- 0.51, - 0.14), P = 0.0005), and LDL (SMD = - 0.38, 95% CI (- 0.50, - 0.27), P < 0.00001), increase HDL level (SMD = 0.66, 95% CI (0.56, 0.76), P < 0.00001), and plasma glucose level in the patients (SMD = 0.27, 95% CI (0.12, 0.42), P = 0.0004). Subgroup analysis showed that supplementation of NA had the most significant effect on the levels of TG, TC, LDL, HDL and plasma glucose. CONCLUSIONS In this study, a meta-analysis based on currently published clinical trials with NAD+ precursors showed that supplementation with NAD+ precursors improved TG, TC, LDL, and HDL levels in humans, but resulted in hyperglycemia, compared with placebo or no treatment. Among them, NA has the most significant effect on improving lipid metabolism. In addition, although NR and NAM supplementation had no significant effect on improving human lipid metabolism, the role of NR and NAM could not be directly denied due to the few relevant studies at present. Based on subgroup analysis, we found that the supplement of NAD+ precursors seems to have little effect on healthy people, but it has a significant beneficial effect on patients with cardiovascular disease and dyslipidemia. Due to the limitation of the number and quality of included studies, the above conclusions need to be verified by more high-quality studies.
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Affiliation(s)
- Ou Zhong
- Hengyang Medical School, University of South China, Hengyang, 421001, China
| | - Jinyuan Wang
- Hengyang Medical School, University of South China, Hengyang, 421001, China
| | - Yongpeng Tan
- Hengyang Medical School, University of South China, Hengyang, 421001, China
| | - Xiaocan Lei
- Hengyang Medical School, University of South China, Hengyang, 421001, China.
| | - Zhihan Tang
- Hengyang Medical School, University of South China, Hengyang, 421001, China.
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Scolaro B, Soo Jin Kim H, de Castro IA. Bioactive compounds as an alternative for drug co-therapy: Overcoming challenges in cardiovascular disease prevention. Crit Rev Food Sci Nutr 2017; 58:958-971. [PMID: 27830947 DOI: 10.1080/10408398.2016.1235546] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Different pharmacological interventions have been applied with success to reduce the progression of atherosclerosis. However, many patients are not good responders or must interrupt treatment due to adverse effects. Bioactive compounds such as omega-3 fatty acids (n-3 FA), plant sterol esters (PSE) and phenolic compounds (PHC) are natural molecules with great potential to reduce the atherosclerosis burden by reducing inflammation, LDL cholesterol (LDL-C) and oxidative stress, respectively. Although their physiological effects on biomarkers are much lower than those expected by drugs used for the same purpose, bioactive compounds can easily be incorporated into the daily diet and present no adverse effects. However, little is known about the combination of n-3 FA, PSE, PHC, and drugs in atherosclerosis progression. This review article summarizes potential effects of co-therapies involving n-3 FA, PSE, and PHC combined with major hypolipidemic drugs on atherosclerosis biomarkers and clinical outcomes. Evidence of additive and/or complementary effects regarding drugs action reveals possible roles for bioactive compounds in disease management. Pharmaceutical companies, physicians, and food scientists should be prepared to better understand this type of interaction and its consequences in terms of efficacy and life quality.
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Affiliation(s)
- Bianca Scolaro
- a Faculty of Pharmaceutical Sciences, Department of Food and Experimental Nutrition , University of São Paulo , São Paulo - SP , Brazil
| | - Hellen Soo Jin Kim
- a Faculty of Pharmaceutical Sciences, Department of Food and Experimental Nutrition , University of São Paulo , São Paulo - SP , Brazil
| | - Inar Alves de Castro
- a Faculty of Pharmaceutical Sciences, Department of Food and Experimental Nutrition , University of São Paulo , São Paulo - SP , Brazil
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McKenney JM. Combination Treatment with Atorvastatin plus Niacin Provides Effective Control of Complex Dyslipidemias: A Literature Review. Postgrad Med 2015; 124:7-20. [DOI: 10.3810/pgm.2012.01.2513] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Shearer GC, Pottala JV, Hansen SN, Brandenburg V, Harris WS. Effects of prescription niacin and omega-3 fatty acids on lipids and vascular function in metabolic syndrome: a randomized controlled trial. J Lipid Res 2012; 53:2429-35. [PMID: 22892157 PMCID: PMC3466011 DOI: 10.1194/jlr.p022392] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The metabolic syndrome includes both dyslipidemia and impaired vascular function.
Because extended-release niacin (ERN) and prescription omega-3 acid ethyl-esters
(P-OM3) independently improve these characteristics, we tested their effects in
combination. Sixty metabolic syndrome subjects were randomized to 16 weeks of
treatment on dual placebo, P-OM3 (4g/day), ERN (2 g/day), or combination in a
double-blind trial. Lipoprotein subfractions and vascular endpoints were measured and
tested using ANCOVA. ERN increased HDL cholesterol by 5.4 mg/dl from baseline
(P = 0.04), decreased triglycerides (TG) by 39 mg/dl
(−21%, P = 0.003), and decreased the augmentation
index, which is a measure of vascular stiffness, by 3.5 units (P
= 0.04). P-OM3 reduced TG by 26 mg/dl (−13%, P =
0.04). Combination treatment increased HDL cholesterol by 7.8 mg/dl
(P = 002) and decreased TG by 72 mg/dl (−34%) but
there was no improvement in vascular stiffness. Detailed analysis of lipoprotein
subfractions revealed increased large, bouyant HDL2 (3.3 mg/dl;
P = 0.002) and decreased VLDL1+2
(−32%; P < 0.0001), among subjects treated with combination
therapy, that were not present with either therapy alone. ERN and P-OM3 alone
improved characteristics of metabolic syndrome; however, whereas subjects on
combination therapy did not have improved vascular stiffness, TG and HDL levels
improved as did certain lipoprotein subfractions.
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Affiliation(s)
- Gregory C Shearer
- Sanford Research/USD, University of South Dakota, Sioux Falls, SD, USA.
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Kanji S, Seely D, Yazdi F, Tetzlaff J, Singh K, Tsertsvadze A, Tricco AC, Sears ME, Ooi TC, Turek MA, Skidmore B, Ansari MT. Interactions of commonly used dietary supplements with cardiovascular drugs: a systematic review. Syst Rev 2012; 1:26. [PMID: 22651380 PMCID: PMC3534595 DOI: 10.1186/2046-4053-1-26] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Accepted: 04/18/2012] [Indexed: 11/10/2022] Open
Abstract
UNLABELLED BACKGROUND The objective of this systematic review was to examine the benefits, harms and pharmacokinetic interactions arising from the co-administration of commonly used dietary supplements with cardiovascular drugs. Many patients on cardiovascular drugs take dietary supplements for presumed benefits and may be at risk for adverse supplement-drug interactions. METHODS The Allied and Complementary Medicine Database, the Cochrane Library, EMBASE, International Bibliographic Information on Dietary Supplements and MEDLINE were searched from the inception of the review to October 2011. Grey literature was also reviewed.Two reviewers independently screened records to identify studies comparing a supplement plus cardiovascular drug(s) with the drug(s) alone. Reviewers extracted data using standardized forms, assessed the study risk of bias, graded the strength of evidence and reported applicability. RESULTS Evidence was obtained from 65 randomized clinical trials, 2 controlled clinical trials and 1 observational study. With only a few small studies available per supplement, evidence was insufficient for all predefined gradable clinical efficacy and harms outcomes, such as mortality and serious adverse events. One long-term pragmatic trial showed no benefit from co-administering vitamin E with aspirin on a composite cardiovascular outcome. Evidence for most intermediate outcomes was insufficient or of low strength, suggesting no effect. Incremental benefits were noted for triglyceridemia with omega-3 fatty acid added to statins; and there was an improvement in levels of high-density lipoprotein cholesterol with garlic supplementation when people also consumed nitrates CONCLUSIONS Evidence of low-strength indicates benefits of omega-3 fatty acids (plus statin, or calcium channel blockers and antiplatelets) and garlic (plus nitrates or warfarin) on triglycerides and HDL-C, respectively. Safety concerns, however, persist.
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Affiliation(s)
- Salmaan Kanji
- Clinical Epidemiology, The Ottawa Hospital Research Institute and the Department of Pharmacy, The Ottawa Hospital, Ottawa, ON, Canada
| | - Dugald Seely
- Clinical Epidemiology, The Ottawa Hospital Research Institute and the Department of Pharmacy, The Ottawa Hospital, Ottawa, ON, Canada
- Department of Research & Clinical Epidemiology, The Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | - Fatemeh Yazdi
- Ottawa Methods Centre, Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa Evidence-based Practice Center, Ottawa, ON, Canada
| | - Jennifer Tetzlaff
- Ottawa Methods Centre, Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa Evidence-based Practice Center, Ottawa, ON, Canada
| | - Kavita Singh
- Ottawa Methods Centre, Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa Evidence-based Practice Center, Ottawa, ON, Canada
| | - Alexander Tsertsvadze
- Ottawa Methods Centre, Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa Evidence-based Practice Center, Ottawa, ON, Canada
| | - Andrea C Tricco
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, ON, Canada
| | - Margaret E Sears
- Ottawa Methods Centre, Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa Evidence-based Practice Center, Ottawa, ON, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Teik C Ooi
- Division of Endocrinology and Metabolism, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Michele A Turek
- Division of Cardiology, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Becky Skidmore
- Division of Cardiology, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Mohammed T Ansari
- Ottawa Methods Centre, Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa Evidence-based Practice Center, Ottawa, ON, Canada
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Shearer GC, Savinova OV, Harris WS. Fish oil -- how does it reduce plasma triglycerides? Biochim Biophys Acta Mol Cell Biol Lipids 2011; 1821:843-51. [PMID: 22041134 DOI: 10.1016/j.bbalip.2011.10.011] [Citation(s) in RCA: 183] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Revised: 10/07/2011] [Accepted: 10/10/2011] [Indexed: 01/30/2023]
Abstract
Long chain omega-3 fatty acids (FAs) are effective for reducing plasma triglyceride (TG) levels. At the pharmaceutical dose, 3.4g/day, they reduce plasma TG by about 25-50% after one month of treatment, resulting primarily from the decline in hepatic very low density lipoprotein (VLDL-TG) production, and secondarily from the increase in VLDL clearance. Numerous mechanisms have been shown to contribute to the TG overproduction, but a key component is an increase in the availability of FAs in the liver. The liver derives FAs from three sources: diet (delivered via chylomicron remnants), de novo lipogenesis, and circulating non-esterified FAs (NEFAs). Of these, NEFAs contribute the largest fraction to VLDL-TG production in both normotriglyceridemic subjects and hypertriglyceridemic, insulin resistant patients. Thus reducing NEFA delivery to the liver would be a likely locus of action for fish oils (FO). The key regulator of plasma NEFA is intracellular adipocyte lipolysis via hormone sensitive lipase (HSL), which increases as insulin sensitivity worsens. FO counteracts intracellular lipolysis in adipocytes by suppressing adipose tissue inflammation. In addition, FO increases extracellular lipolysis by lipoprotein lipase (LpL) in adipose, heart and skeletal muscle and enhances hepatic and skeletal muscle β-oxidation which contributes to reduced FA delivery to the liver. FO could activate transcription factors which control metabolic pathways in a tissue specific manner regulating nutrient traffic and reducing plasma TG. This article is part of a Special Issue entitled Triglyceride Metabolism and Disease.
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Affiliation(s)
- Gregory C Shearer
- Cardiovascular Health Research Center, Sanford Research USD, SD, USA.
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