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        Fish Oil May Augment Atorvastatin As Treatment For Dyslipidemia In Obese, Insulin-Resistant Men

        A DGReview of :"Regulatory Effects of HMG CoA Reductase Inhibitor and Fish Oils on Apolipoprotein B-100 Kinetics in Insulin-Resistant Obese Male Subjects With Dyslipidemia"
        Diabetes

        08/07/2002
        By Andrew A. Skolnick


        Fish oil supplements may augment the ability of atorvastatin to control dyslipidemia in obese, insulin-resistant men.

        In a placebo controlled trial involving 48 obese, insulin-resistant men with dyslipidemia, D.C. Chan, at the University of Western Australia, in Crawley, Australia, and colleagues studied the differential effects of fish oils (4 gm/day) and atorvastatin (40 mg/day) on lipid metabolism.

        Hepatic accumulation of lipid substrates perturbs apolipoproteinB-100 (apoB) metabolism in insulin-resistant, obese patients and may account for their increased risk of cardiovascular disease, the researchers said.

        In their study, they found the HMG coA reductase inhibitor atorvastatin significantly decreased plasma apoB-containing lipoproteins by increasing the fractional catabolic rate of very low density lipoprotein-apoB, intermediate density lipoprotein-apoB, and low density lipoprotein-apoB.

        They also found that fish oils significantly decreased plasma levels of triglycerides and very low density lipoprotein-apoB, decreased the very low density lipoprotein-apoB secretion rate, but increased the conversion of very low density lipoprotein to low density lipoprotein.

        Compared with placebo, combined treatment with atorvastatin and fish oils decreased very low density lipoprotein-apoB secretion and increased the fractional catabolic rate of apoB in each lipoprotein fraction , as well as the percent conversion of very low density lipoprotein to low density lipoprotein. None of the treatments altered insulin resistance, the researchers reported.

        The investigators concluded that, "atorvastatin increased hepatic clearance of all apoB-containing lipoproteins, whereas fish oils decreased hepatic secretion of very low density lipoprotein-apoB. The differential effects of atorvastatin and fish oils on apoB kinetics support their combined use in correcting defective apoB metabolism in obese, insulin-resistant subjects."
        Diabetes 2002; 8: 2377-2386. "Regulatory Effects of HMG CoA Reductase Inhibitor and Fish Oils on Apolipoprotein B-100 Kinetics in Insulin-Resistant Obese Male Subjects With Dyslipidemia"

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