BACKGROUND: Some epidemiological, clinical and experimental studies have shown that intake of n-3 fatty acids (FA) lowers the incidence of coronary heart disease (CHD). The effects of fish oil and n-3 FA on the development of atherosclerosis include several factors such as the platelet-vascular wall interaction, modulation of eicosanoid metabolism as well as platelet aggregation and its survival time. There were also changes in the fibrinolytic system and cardiovascular reactivity observed. Effects of n-3 FA on lipid and lipoprotein metabolism exert antiatheromatous action as well. The aim of the study was to evaluate changes in plasma lipid risk factors for CHD in subjects with primary hyperlipoproteinemia (HLP) after the administration of fish oil rich in n-3 FA. METHODS AND RESULTS: A total of 82 patients (61 men and 21 women) were administered fish oil (3.5 g n-3 FA daily) for a period of 3 weeks. The group of hyperlipidemics included 9 patients with HLP IIA, 29 with HLP IIB, and 35 with HLP IV. Seven patients had HLP type V while two had HLP type III. Intake of fish oil led to a mild decrease in total plasma cholesterol which was significant in the whole group and in HLP type V. Triglyceride levels declined significantly in all HLP phenotypes, with the changes being most marked in HLP types IIB, IV, and V. We also observed a significant increase in cholesterol concentration in HDL and in the both HDL2 and HDL3 subfractions in the whole group and all HLP phenotypes as well. On the other hand no statistical significant changes were observed in LDL-cholesterol levels. The levels of apo B rose significantly only in HLP type V. A statistically significant increase was found in apo A-1 levels in the whole group and in the HLP IIB subgroup. Fish oil administration led to a mild reduction in diastolic pressure and uricemia. In part of patients fish oil induced decrease in lipoprotein(a) concentration was observed.

4 interní klinika 1 lékarské fakulty Univerzity Karlovy a Vseobecné fakultní nemocnice Praha