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The Role of Nutrition and Nutritional Supplements in the Treatment of Dyslipidemia
Published in Stephen T. Sinatra, Mark C. Houston, Nutritional and Integrative Strategies in Cardiovascular Medicine, 2015
Observational, epidemiologic, and controlled clinical trials have shown significant reductions in serum TG, VLDL, decreased LDL-P, and increased LDL and HDL particle size as well as major reductions in all CVD events.5,87–94 The DART trial demonstrated a decrease in mortality of 29% in men post MI and the Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto (GISSI) prevention trial found a decrease in total mortality of 20%, CV deaths of 30% and sudden death of 45%. The Kuppio Heart Study demonstrated a 44% reduction in fatal and nonfatal CHD in subjects in the highest quintile of omega-3 intake compared to the lowest quintile.5,87,88 Omega-3 FA reduce CHD progression, stabilize plaque, reduce coronary artery stent restenosis, and coronary artery bypass graft eicosapentaenoic acid (CABG) occlusion.5,89 In the JELIS study, the addition of 1.8 g of omega EPA to a statin resulted in an additional 19% relative risk reduction (RRR) in major coronary events and nonfatal MI and a 20% decrease in CVA.5,90 There is a dose-related reduction in VLDL of up to 50%, TG of up to 50%, with little to no change or decrease in total TC, LDL, APO-B and no change to slight increase in HDL.5,91–94 However, the number of LDL particles decrease and LDL particle size increases from small type B to large type A (increase of 25 nm). The antiatherogenic HDL 2b is also increases by up to 29%. The rate of entry of VLDL particles into the circulation is decreased and APO-CIII is reduced which allows lipoprotein lipase to be more active.26 There is a decrease in remnant chylomicrons and remnant lipoproteins.5,92 Patients with LDL over 100 mg% usually have reductions in total LDL and those that are below 80 mg% have mild increases.93 However, in both cases, the LDL-P decreases, the dense LDL B increases in size to the less atherogenic LDL A particle and APO-B levels decrease. There is a net decrease in the concentration of cholesterol carried by all atherogenic particles and decreases in non-HDL-C. Omega-3 FA are anti-inflammatory, antithrombotic, lower BP and heart rate, improve heart rate variability,5,87 decrease FA synthesis, increase FA oxidation, and reduce body fat and weight.5 Omega-3 FAs are one of the only substances that lower lipoprotein-associated phospholipase A2 (Lp-LPA2).26
Lipoprotein-associated phospholipase A2 (Lp-PLA2) – possible diagnostic and risk biomarker in chronic ischaemic heart disease
Published in Journal of Enzyme Inhibition and Medicinal Chemistry, 2021
Adriana Diaconu, Bogdan-Ioan Coculescu, Gheorghe Manole, Horațiu Vultur, Elena Claudia Coculescu, Cristina Maria Stocheci, Ioan-Sorin Tudorache, Alexandra-Ligia Dincă, Valeriu Gabi Dincă
3. In support of the proposal that the serum level of Lp-PLA2 may be a possible risk biomarker in chronic ischaemic heart disease come the values of the incidence of hyper-Lp-LPA2-emy found at admission and discharge (Table 1 and Figure 5).