Abstract 4139: Addition of Omega-3 Fatty Acids to Rosuvastatin Improves Endothelial Function in South Asians with Metabolic Syndrome
Background Metabolic syndrome is increasing in prevalence and is associated with significant endothelial dysfunction. Omega-3 fatty acids (O3FA) modulate the lipid profile and improve endothelial function. South Asian population is a group with the highest rates of metabolic syndrome. We used the brachial artery reactivity to test the hypothesis that the addition of O3FA to rosuvastatin (RO) would further improve endothelial function compared to RO alone in this population.
Methods South Asian patients with metabolic syndrome were randomized in a crossover design, after a 4-week statin washout. The treatment group (n=14) received 4 weeks of O3FA (Fish oil capsules 4g DHA/EPA) plus RO 10mg followed by 4 weeks of RO alone; the control group (n=16) received the same drug regimen in reverse order. Endothelial function and fasting blood samples were obtained at baseline and at the end of each drug regimen. A sample size of 30 patients detects a 10% improvement in endothelial function withα: 0.05 and β: 80%.
Results 30 patients, mean age of 51 (27–78), 33% diabetics, completed the study. Compared to baseline, O3FA plus RO improved endothelial-dependent vasodilation (EDV) and endothelial-independent vasodilation (EIV) (EDV: -1.4% to 14.6%, p=0.001), (EIV: 3% to 17%, p=0.002). When O3FA were removed, these effects were lost (EDV: 14.6% to 0.6%, p< 0.003; EIV 17% to 8.7%, p=0.03). In the control arm (n=16), compared to baseline, RO alone did not improve EDV (-2.5% to -1%, p=0.5) nor EIV (10.3% to 11%, p=0.6). However, when O3FA were added to RO, there was a significant improvement in EDV(-1% to 14.7%, p=0.001) and EIV (11% to 24%, p=0.001). Addition of O3FA significantly improved the lipid profile (TGL 202 to 110 mg/dl, p<0.001, LDL 112 to 81 mg/dl, p=0.01, HDL 41 to 43 mg/dl, p=NS).
Conclusion The addition of O3FA to RO further improves endothelium-dependent and endothelium-independent vasodilation as well as the lipid profile in South Asians with metabolic syndrome. These effects are lost with the removal of O3FA.