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Effects of omega-3 polyunsaturated fatty acids on metabolically active hormones in patients post-myocardial infarction.

Patel JV, Lee KW, Tomson J, Dubb K, Hughes EA, Lip GY

Haemostasis Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham B18 7QH, UK.

BACKGROUND: Long-chain omega-3 polyunsaturated fatty acids (PUFA) supplementation is used as a therapeutic secondary prevention strategy among post-myocardial infarction (MI) patients. The effects of omega-3 PUFA on markers of energy homeostasis among post-MI patients are unclear. METHODS: We investigated the effects of Omacor (a pharmaceutical capsule formulation of highly refined, concentrated omega-3 PUFA; Solvay Healthcare, Southampton, UK; 1 g/day) in addition to usual care (cardiovascular therapy) in a pilot randomised study of 35 post-MI men. Following randomisation to Omacor (n=16), or 'usual care' controls (n=19), fasting levels of insulin, non-esterified fatty acids (NEFA), triglycerides, glucose and adipocytokines (adiponectin, leptin and tumour necrosis factor (TNF)-alpha), as indices of markers of energy homeostasis, were measured at baseline and after 3-month treatment. RESULTS: There were no baseline differences in age, body mass index, blood pressure, fasting triglycerides, plasma glucose, NEFA and adipocytokines between the two treatment arms (P=0.07). There were no significant changes in metabolically active hormones within groups after 3-month treatment. Across arms, the direction of baseline to follow-up changes in insulin levels were significantly different (P= 0.03), with a mean increase with Omacor (+3.39 mU/ml) and a decrease among controls (-17.6 mU/ml), without associated deteriorating changes in triglycerides, NEFA or plasma glucose. CONCLUSION: This pilot study suggests that Omacor had little effect on glycaemic control among male post-MI patients. However, Omacor was associated with raised insulin levels, compared to usual care; thus, a metabolic basis for the cardioprotective action of Omacor, outside of its lipid lowering effects, merits further investigation.

Published 12 December 2006 in Int J Cardiol, 115(1): 42-5.
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