Hyperlipoproteinemia type IV

Effects of Fish Oil on Hypertriglyceridemia Fish oil preparations have been widely promoted as a means of reducing triglyceride and very-low-density lipoprotein (VLDL) cholesterol levels. Harris and colleagues report on the use of a low-saturated fat, low-cholesterol fish oil supplement in patients with hypertriglyceridemia.

The authors studied 11 patients (mean age: 50 years) with isolated hypertriglyceridemia (Type IV) and seven patients (mean age: 58 years) with concomitant hypercholesterolemia (Type IIb). A single-blind, placebo-controlled, crossover design was utilized. Patients had been previously instructed in a low-cholesterol low-fat diet and were told to make no further changes in their diet. Patients received 121-g capsules of fish oil or placebo (safflower oil) daily for six weeks. Mean body weights varied by less than 1 kg from prestudy values. No serious side effects from the fish oil preparation occurred. One patient noted that diarrhea developed whenever the capsules were taken on an empty stomach, but this effect was prevented by postprandial ingestion of the capsules.

When compared with placebo, fish oil use was associated with a reduction in triglyceride and VLDL levels and an increase in low-density lipoprotein (LDL) cholesterol levels. No statistically significant effect on high-density lipoprotein (HDL) cholesterol levels was noted.

An increased risk of coronary heart disease has been linked to LDL cholesterol levels. Because fish oil supplementation was found to raise LDL levels, the authors suggest that the promotion of fish oil as a healthful substance may be inappropriate. Careful monitoring of plasma lipid responses to fish oil supplementation is necessary. The long-term effects of fish oil supplementation in hypertriglyceridemic patients merit further study before definitive recommendations are developed. (Annals of Internal Medicine, September 15, 1988, vol. 109, p. 465.)

COPYRIGHT 1989 American Academy of Family Physicians
COPYRIGHT 2004 Gale Group