Highlights
- •Niacin plus omega-3 therapy was tested in overweight dyslipidemic patients.
- •This combination is more potent in normalizing apolipoprotein parameters.
- •These changes are consistent with effects of this combination on plasma lipids.
- •Combo therapy normalized apoC3 glycosylation.
Abstract
Objective
Prescription omega-3 acid ethyl esters (P-OM3) and extended release niacin (ERN) both
have beneficial effects on plasma lipids and lipoproteins. The purpose of this study
was to describe the effects of mono- and combination (Combo) therapy of these agents
in patients with the metabolic syndrome.
Methods
Very low density (VLDL), intermediate/low density (IDL/LDL, hereafter LDL), and high
density lipoproteins (HDL) were isolated from 56 overweight patients with elevated
triglyceride/HDL-C ratios at baseline and after 16 weeks of treatment with placebo,
ERN (2g/day), P-OM3 (4g/day), or Combo and then analyzed by quantitative electrophoresis
for apolipoproteins (apo) A1, A2, B, C2, C3 and E. Total plasma concentrations and
the ratios of each apo with apoB (in VLDL and LDL) and with apoA1 (in HDL) were calculated.
An apoC3 glycosylation index (a ratio between di- and mono-sialylated isoforms) was
also determined in plasma and in each lipoprotein fraction.
Results
ERN reduced plasma apoB (−11%, p < 0.05). Combo increased LDL apoE/apoB ratio (64%,
p < 0.01) and LDL apoA1/apoB (91%, p < 0.05). ERN increased the apoC3 glycosylation
index only in HDL (37%, p < 0.05), whereas P-OM3 and Combo increased the index in
whole plasma (48% and 49%, respectively, p < 0.05 for both) and in every lipoprotein
class (VLDL: 26%, p < 0.01 and 26%, p < 0.05; LDL: 55%, p < 0.01 and 61%, p < 0.01;
HDL: 43%, p < 0.001 and 44%, p < 0.001, respectively). All findings were significant
after adjustment for age, sex, body mass index (BMI), smoking, medications, and baseline
apo value.
Conclusions
ERN produced a beneficial reduction in plasma apoB. The enrichment of LDL with apoE
and apoA1 was unique to the Combo group and might be beneficial owing to the atheroprotective
properties of apoE and HDL2 (a likely source of apoA1 in LDL fraction). The effect
of therapies on the apoC3 glycosylation index is a novel finding, the implications
of which will require further study.
Keywords
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Article info
Publication history
Published online: April 22, 2015
Accepted:
April 21,
2015
Received in revised form:
March 27,
2015
Received:
October 23,
2014
Identification
Copyright
© 2015 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
