Omega 3 Fatty acids in the news, The rest of the story.

• Omega 3 fatty acids had their moment in the news yesterday .
• 
  
•  The headline , omega 3's have no effect in reducing the risk of cardiovascular disease. 
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• I believe they were referring to the ORIGIN study. This was a large study, 12,537 people with high risk for cardio vascular disease who had impaired fasting glucose , impaired glucose tolerance ,or recent onset of type 2 diabetes. 
•  The ORIGIN Trial Investigators. N-3 fatty acids and cardiovascular outcomes in patients with dysglycemia. N Engl J Med. 2012; Jun 11. Epub ahead of print.
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• End points
•  Primary end points cardiovascular death , secondary end points 
• Secondary end points , nonfatal heart attack or stroke ,all cause mortality or arrhythmic death
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• The purpose was to answer 2 questions
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•  #1 Question -
•       To investigate wether insulin replacement with Glargine ( Lantus insulin ) and
•       maintaining a fasting glucose below 95mg/dl (5.3 mm/l) would reduce the risk 
•       of cardiovascular disease.
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•      Answer - 
•                       No , there was no significant reduction in cardiovascular outcome in
•                       the insulin group
•                   
•     The rest of the story   
•                       There was no increase in the risk of developing cancer.
•                       There was a decrease in the progression to type 2 diabetes with
•                       maintaining a normal fasting glucose.
•                   
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•   # 2 Question
•        To evaluate cardiovascular risk in patients taking  1 capsule  containing 
•         900 mg of  omega 3 fatty acid
•       
•             
•        Answer - there was no reduction in cardiovascular risk  over the 6.2 years of 
•                         the study.
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•       The rest of the story and comment
•                      baseline Triglycerides 152 mg/dl 
•                                       LDL cholesterol 112 mg/dl
•                     The treatment group  had a 23.5 mg/dl decrease in triglycerides 
•                     compared to a 9% decrease in the placebo group. 
•                     and  no significant  decrease in LDL  or increase in HDL. They did 
•                     demonstrate that a small dose has a small effect on lipids.
•                  .

                   Comment. 

                        The good news in the rest of this story is that early aggressive correction

                        of glucose can slow the progression of type 2 diabetes . 

                        

                        The finding of no increase in the risk of cancer in patients using glargine 

                         (Lantus )relieves some of the early concerns about glargine and cancer.

                        

                        Omega 3 fatty acids are effective for reducing abnormally elevated

                        triglyceride. The average baseline  triglyceride level in the study was 152 

                        mg/dl( normal < 150 mg/dl ) .

                       

                        This was a research study, in patients with no clinical indication for using

                        omega 3 fatty acids , and they successfully demonstrated that there was 

                        no benefit in  taking low dose ( < 1 gram ) of omega -3 - fatty acid.

                       

                       The therapeutic dose for elevated triglycerides is 4 to 6 grams of fatty 

                        acids EPA and DHA. Most of the patients would not have received
                        omega -3 -Fatty acid in their doctors office and would have instead
                        received a recommendation to adjust their statins  to correct their LDL 
                        cholesterol to < 70 mg/dl.

                      

             I have attached some of my previous blogs for your review on this topic.

Have fun , Be Smart and read the details
David calder,MD

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