Anti-inflammatory and cardioprotective effects of n-3 polyunsaturated fatty acids and plant sterols in hyperlipidemic individuals

• Published in: Atherosclerosis 2009-06, Vol.204 (2), p.476-482
• Main Authors: Micallef, Michelle A, Garg, Manohar L
• Format: Article
• Language: English
• Subjects: Administration, Oral; Adult; Aged; Anti-Inflammatory Agents - administration & dosage; Anti-Inflammatory Agents - blood; Anti-Inflammatory Agents - therapeutic use; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure; Body Composition; Capsules; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Cardiovascular Diseases - blood; Cardiovascular Diseases - etiology; Cardiovascular Diseases - physiopathology; Cardiovascular Diseases - prevention & control; Cardiovascular system; Dietary Supplements; Double-Blind Method; Fatty Acids, Omega-3 - administration & dosage; Fatty Acids, Omega-3 - blood; Fatty Acids, Omega-3 - therapeutic use; Female; Humans; Hyperlipidemia; Hyperlipidemias - blood; Hyperlipidemias - complications; Hyperlipidemias - diet therapy; Hyperlipidemias - physiopathology; Hypolipidemic Agents - administration & dosage; Hypolipidemic Agents - blood; Hypolipidemic Agents - therapeutic use; Inflammation; Inflammation Mediators - blood; Lipids - blood; Male; Medical sciences; Middle Aged; Omega-3 fatty acids; Pharmacology. Drug treatments; Phytosterols - administration & dosage; Phytosterols - blood; Phytosterols - therapeutic use; Plant sterols; Risk Assessment; Risk Factors; Treatment Outcome; Vasodilator agents. Cerebral vasodilators
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2008.09.020

Abstract Background Risk factors of cardiovascular disease such as lipid aberrations, hypertension, abdominal adiposity and elevations in systemic inflammation, are prominent aetiologies in hyperlipidemia. Supplementation with n-3 PUFA is associated with a reduction in cardiovascular events through its hypotriglyceridemic, anti-aggregatory and anti-inflammatory properties. Plant sterols have potent hypocholesterolemic properties, although their effect on the inflammatory cascade is uncertain. This study investigated the effect of combined supplementation with n-3 PUFA and plant sterols on cardiovascular risk factors, blood pressure, body composition, markers of systemic inflammation and overall risk, in hyperlipidemic individuals. Methods The study was a 3-week randomised, double-blind, placebo-controlled, 2 × 2 factorial design, in four parallel groups. Sixty hyperlipidemic participants were randomised to recieve either sunola oil or 1.4 g/d n-3 PUFA capsules with or without 2 g plant sterols per day. Results The combination of n-3 PUFA and plant sterols reduced several inflammatory markers. High sensitivity C-reactive protein (hs-CRP) was reduced by 39% ( P = 0.009), tumor necrosis factor-α (TNF-α) by 10% ( P = 0.02), interleukin-6 (IL-6) by 10.7% ( P = 0.009), leukotriene B4 (LTB4 ) by 29.5% ( P = 0.01) and adiponectin was increased by 29.5% ( P = 0.05). Overall cardiovascular risk was reduced by 22.6% ( P = 0.006) in the combination group. Conclusion We have demonstrated, for the first time that dietary intervention with n-3 PUFA and plant sterols reduces systemic inflammation in hyperlipidemic individuals. Furthermore, our results suggest that reducing inflammation provides a potential mechanism by which the combination of n-3 PUFA and plant sterols are cardioprotective.