ABSTRACT
OBJECTIVES: To determine the efficacy of 4 g/day fish oil to lower triglycerides and impact lipoprotein particles, inflammation, insulin resistance, coagulation, and thrombosis. STUDY DESIGN: Participants (n = 42, age 14 ± 2 years) with hypertriglyceridemia and low-density lipoprotein (LDL) cholesterol <160 mg/dL were enrolled in a randomized, double-blind, crossover trial comparing 4 g of fish oil daily with placebo. Treatment interval was 8 weeks with a 4-week washout. Lipid profile, lipoprotein particle distribution and size, glucose, insulin, high-sensitivity C-reactive protein, interleukin-6, fibrinogen, plasminogen activator inhibitor-1, and thrombin generation were measured. RESULTS: Baseline lipid profile was total cholesterol 194 (5.4) mg/dL (mean [SE]), triglycerides 272 (21) mg/dL, high-density lipoprotein cholesterol 39 (1) mg/dL, and LDL cholesterol 112 (3.7) mg/dl. LDL particle number was 1614 (60) nmol/L, LDL size was 19.9 (1.4) nm, and large very low-density lipoprotein/chylomicron particle number was 9.6 (1.4) nmol/L. Triglycerides decreased on fish oil treatment but the difference was not significant compared with placebo (-52 ± 16 mg/dL vs -16 ± 16 mg/dL). Large very low-density lipoprotein particle number was reduced (-5.83 ± 1.29 nmol/L vs -0.96 ± 1.31 nmol/L; P < .0001). There was no change in LDL particle number or size. There was a trend towards a lower prothrombotic state (lower fibrinogen and plasminogen activator inhibitor-1; .10 > P > .05); no other group differences were seen. CONCLUSIONS: In children, fish oil (4 g/day) lowers triglycerides slightly and may have an antithrombotic effect but has no effect on LDL particles.
Subject(s)
Cholesterol, LDL/blood , Cholesterol, LDL/drug effects , Fish Oils/administration & dosage , Hypertriglyceridemia/blood , Hypertriglyceridemia/drug therapy , Adolescent , Blood Coagulation/drug effects , Cross-Over Studies , Double-Blind Method , Female , Heart Diseases/etiology , Heart Diseases/prevention & control , Humans , Hypertriglyceridemia/complications , Hypertriglyceridemia/metabolism , Inflammation/etiology , Inflammation/prevention & control , Insulin Resistance , Male , Metabolic Diseases/etiology , Metabolic Diseases/prevention & control , Risk Factors , Thrombosis/etiology , Thrombosis/prevention & control , TriglyceridesABSTRACT
Atherosclerosis begins in childhood, and early initiation of prevention through behavioral means may lower the risk of future cardiovascular disease. The obesity epidemic threatens the cardiovascular health of today's children. Genetic dyslipidemias such as familial hypercholesterolemia and the presence of multiple risk factors in the same child or adolescent may require pharmacologic therapy.
Subject(s)
Child , Dyslipidemias/therapy , Atherosclerosis/etiology , Atherosclerosis/prevention & control , Dyslipidemias/diagnosis , Dyslipidemias/drug therapy , Humans , Hypolipidemic Agents/therapeutic use , Metabolic Syndrome/complications , Metabolic Syndrome/epidemiology , Obesity/complications , Obesity/epidemiologyABSTRACT
Paying attention to cholesterol at a young age will prevent future atherosclerosis. Clinicians must teach parents that by making the necessary nutritional and lifestyle changes, they can prevent or lower their child's risk for heart disease, hypertension, and diabetes. Recognition of the occasional child with a genetic dyslipidemia will allow more aggressive lipid-lowering treatment at an age when atherosclerosis is first developing.
