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Effects of eicosapentaenoic acid and docosahexaenoic acid on low-density lipoprotein cholesterol and other lipids: a review.
J Clin Lipidol. 2012 Jan-Feb; 6(1):5-18.JC

Abstract

In this exploratory, hypothesis-generating literature review, we evaluated potentially differential effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and non-HDL-C in published studies of ω-3 fatty acid supplementation or prescription ω-3 fatty acid ethyl esters. Placebo-adjusted changes in mean lipid parameters were compared in randomized, controlled trials in subjects treated for ≥ 4 weeks with DHA or EPA. Of 22 studies identified, 6 compared DHA with EPA directly, 12 studied DHA alone (including 14 DHA-treated groups), and 4 examined EPA alone. In studies directly comparing EPA with DHA, a net increase in LDL-C of 3.3% was observed with DHA (DHA: +2.6%; EPA: -0.7%). In such head-to-head comparative studies, DHA treatment was associated with a net decrease in TG by 6.8% (DHA: -22.4%; EPA: -15.6%); a net increase in non-HDL-C by 1.7% (DHA: -1.2%; EPA -2.9%); and a net increase in HDL-C by 5.9% (DHA: +7.3%; EPA: +1.4%). Increases in LDL-C were also observed in 71% of DHA-alone groups [with demonstrated statistical significance (P < .05) in 67% (8 of 12) DHA-alone studies] but not in any EPA-alone studies. Changes in LDL-C significantly correlated with baseline TG for DHA-treated groups. The range of HDL-C increases documented in DHA-alone vs EPA-alone studies further supports the fact that HDL-C is increased more substantially by DHA than EPA. In total, these findings suggest that DHA-containing supplements or therapies were associated with more significant increases in LDL-C and HDL-C than were EPA-containing supplements or therapies. Future prospective, randomized trials are warranted to confirm these preliminary findings, determine the potential effects of these fatty acids on other clinical outcomes, and evaluate the generalizability of the data to larger and more heterogeneous patient populations.

Authors+Show Affiliations

Office of Health Promotion and Disease Prevention, Department of Medicine, Emory University School of Medicine, Faculty Office Building, 49 Jesse Hill Jr. Drive SE, Atlanta, GA 30303, USA. tjaco02@emory.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

22264569

Citation

Jacobson, Terry A., et al. "Effects of Eicosapentaenoic Acid and Docosahexaenoic Acid On Low-density Lipoprotein Cholesterol and Other Lipids: a Review." Journal of Clinical Lipidology, vol. 6, no. 1, 2012, pp. 5-18.
Jacobson TA, Glickstein SB, Rowe JD, et al. Effects of eicosapentaenoic acid and docosahexaenoic acid on low-density lipoprotein cholesterol and other lipids: a review. J Clin Lipidol. 2012;6(1):5-18.
Jacobson, T. A., Glickstein, S. B., Rowe, J. D., & Soni, P. N. (2012). Effects of eicosapentaenoic acid and docosahexaenoic acid on low-density lipoprotein cholesterol and other lipids: a review. Journal of Clinical Lipidology, 6(1), 5-18. https://doi.org/10.1016/j.jacl.2011.10.018
Jacobson TA, et al. Effects of Eicosapentaenoic Acid and Docosahexaenoic Acid On Low-density Lipoprotein Cholesterol and Other Lipids: a Review. J Clin Lipidol. 2012 Jan-Feb;6(1):5-18. PubMed PMID: 22264569.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of eicosapentaenoic acid and docosahexaenoic acid on low-density lipoprotein cholesterol and other lipids: a review. AU - Jacobson,Terry A, AU - Glickstein,Sara B, AU - Rowe,Jonathan D, AU - Soni,Paresh N, Y1 - 2011/11/03/ PY - 2011/04/04/received PY - 2011/09/12/revised PY - 2011/10/23/accepted PY - 2012/1/24/entrez PY - 2012/1/24/pubmed PY - 2012/5/19/medline SP - 5 EP - 18 JF - Journal of clinical lipidology JO - J Clin Lipidol VL - 6 IS - 1 N2 - In this exploratory, hypothesis-generating literature review, we evaluated potentially differential effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and non-HDL-C in published studies of ω-3 fatty acid supplementation or prescription ω-3 fatty acid ethyl esters. Placebo-adjusted changes in mean lipid parameters were compared in randomized, controlled trials in subjects treated for ≥ 4 weeks with DHA or EPA. Of 22 studies identified, 6 compared DHA with EPA directly, 12 studied DHA alone (including 14 DHA-treated groups), and 4 examined EPA alone. In studies directly comparing EPA with DHA, a net increase in LDL-C of 3.3% was observed with DHA (DHA: +2.6%; EPA: -0.7%). In such head-to-head comparative studies, DHA treatment was associated with a net decrease in TG by 6.8% (DHA: -22.4%; EPA: -15.6%); a net increase in non-HDL-C by 1.7% (DHA: -1.2%; EPA -2.9%); and a net increase in HDL-C by 5.9% (DHA: +7.3%; EPA: +1.4%). Increases in LDL-C were also observed in 71% of DHA-alone groups [with demonstrated statistical significance (P < .05) in 67% (8 of 12) DHA-alone studies] but not in any EPA-alone studies. Changes in LDL-C significantly correlated with baseline TG for DHA-treated groups. The range of HDL-C increases documented in DHA-alone vs EPA-alone studies further supports the fact that HDL-C is increased more substantially by DHA than EPA. In total, these findings suggest that DHA-containing supplements or therapies were associated with more significant increases in LDL-C and HDL-C than were EPA-containing supplements or therapies. Future prospective, randomized trials are warranted to confirm these preliminary findings, determine the potential effects of these fatty acids on other clinical outcomes, and evaluate the generalizability of the data to larger and more heterogeneous patient populations. SN - 1933-2874 UR - https://www.unboundmedicine.com/medline/citation/22264569/Effects_of_eicosapentaenoic_acid_and_docosahexaenoic_acid_on_low_density_lipoprotein_cholesterol_and_other_lipids:_a_review_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1933-2874(11)00745-8 DB - PRIME DP - Unbound Medicine ER -