Recent findings on the health effects of omega-3 fatty acids and statins, and their interactions: do statins inhibit omega-3?

被引:30
作者
de Lorgeril, Michel [1 ]
Salen, Patricia [1 ]
Defaye, Pascal [2 ]
Rabaeus, Mikael [3 ]
机构
[1] Univ Grenoble 1, Fac Med Grenoble, TIMC IMAG CNRS 5525, Lab Coeur & Nutr, F-38054 La Tronche, France
[2] Hop Univ Nord, Serv Cardiol, F-38054 La Tronche, France
[3] Clin La Prairie, CH-1815 Clarens, Montreux, Switzerland
关键词
omega-3 fatty acids; statins; ischemic heart disease; myocardial infarction; randomized clinical trials; epidemiology; mitochondria; insulin resistance; diabetes; n-6 fatty acids; POLYUNSATURATED FATTY-ACIDS; ALPHA-LINOLENIC ACID; CORONARY-HEART-DISEASE; CHOLESTEROL-LOWERING THERAPY; LOW-DENSITY-LIPOPROTEIN; CHRONIC KIDNEY-DISEASE; SUDDEN CARDIAC DEATH; DIETARY FISH-OIL; GISSI-HF TRIAL; CARDIOVASCULAR-DISEASE;
D O I
10.1186/1741-7015-11-5
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Early randomized controlled trials (RCTs) demonstrated the health benefits of omega-3 fatty acids (n-3), whereas recent RCTs were negative. We now address the issue, focusing on the temporal changes having occurred: most patients in recent RCTs are no longer n-3 deficient and the vast majority are now treated with statins. Recent RCTs testing n-3 against arrhythmias suggest that n-3 reduce the risk only in patients not taking a statin. Other recent RCTs in secondary prevention were negative although, in a post-hoc analysis separating statin users and non-users, non-significant protection of n-3 was observed among statin non-users whereas statin users had no effect. Recent RCTs testing statins - after the implementation of the New Clinical Trial Regulation in 2007 - are negative (or flawed) suggesting that the lack of effect of n-3 cannot be attributed to a parallel protection by statins. Finally, statins favor the metabolism of omega-6 fatty acids (n-6), which in turn inhibits n-3 and, contrary to n-3, they increase insulin resistance and the risk of diabetes. Thus, n-3 and statins are counteractive at several levels and statins appear to inhibit n-3.
引用
收藏
页数:13
相关论文
共 152 条
[1]   Dietary (n-3) long-chain polyunsaturated fatty acids inhibit ischemia and reperfusion arrhythmias and infarction in rat heart not enhanced by ischemic preconditioning [J].
Abdukeyum, Grace G. ;
Owen, Alice J. ;
McLennan, Peter L. .
JOURNAL OF NUTRITION, 2008, 138 (10) :1902-1909
[2]   Mitochondrial Dysfunction, Insulin Resistance, and Type 2 Diabetes Mellitus [J].
Abdul-Ghani, Muhammad A. ;
DeFronzo, Ralph A. .
CURRENT DIABETES REPORTS, 2008, 8 (03) :173-178
[3]   Dietary α-linolenic acid intake and risk of sudden cardiac death and coronary heart disease [J].
Albert, CM ;
Oh, K ;
Whang, W ;
Manson, JE ;
Chae, CU ;
Stampfer, MJ ;
Willett, WC ;
Hu, FB .
CIRCULATION, 2005, 112 (21) :3232-3238
[4]   Fish consumption and risk of sudden cardiac death [J].
Albert, CM ;
Hennekens, CH ;
O'Donnell, CJ ;
Ajani, UA ;
Carey, VJ ;
Willett, WC ;
Ruskin, JN ;
Manson, JE .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1998, 279 (01) :23-28
[5]  
[Anonymous], 2009, ADV COMM M ROS 12 NO
[6]  
Baer AN, 2007, CURR OPIN RHEUMATOL, V19, P67
[7]   Stopping Randomized Trials Early for Benefit and Estimation of Treatment Effects Systematic Review and Meta-regression Analysis [J].
Bassler, Dirk ;
Briel, Matthias ;
Montori, Victor M. ;
Lane, Melanie ;
Glasziou, Paul ;
Zhou, Qi ;
Heels-Ansdell, Diane ;
Walter, Stephen D. ;
Guyatt, Gordon H. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2010, 303 (12) :1180-1187
[8]   Dietary fish oil reduces the incidence of triggered arrhythmias in pig ventricular myocytes [J].
Berecki, Geza ;
Den Ruijter, Hester M. ;
Verkerk, Arie O. ;
Schumacher, Cees A. ;
Baartscheer, Antonius ;
Bakker, Diane ;
Boukens, Bastiaan J. ;
van Ginneken, Antoni C. G. ;
Fiolet, Jan W. T. ;
Opthof, Tobias ;
Coronel, Ruben .
HEART RHYTHM, 2007, 4 (11) :1452-1460
[9]  
Biddle Justin., 2007, SOC EPISTEMOL, V21, P21, DOI [DOI 10.1080/02691720601125472, 10.1080/02691720601125472]
[10]   PREVENTION OF ISCHEMIA-INDUCED VENTRICULAR-FIBRILLATION BY OMEGA-3-FATTY-ACIDS [J].
BILLMAN, GE ;
HALLAQ, H ;
LEAF, A .
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 1994, 91 (10) :4427-4430