Treatment of Hypertriglyceridemia with Omega-3 Fatty Acids: A Systematic Review

• Main Author: Lewis, Amanda Gloria
• Format: Others
• Published: BYU ScholarsArchive 2004
• Subjects: Long-chain omega-3 fatty acids; eicosapentaenoic acid (EPA); docosahexaenoic acid (DHA); hypertriglyceridemia; hyperlipidemia; systematic review; critical appraisal; alpha linolenic acid; omega-6 fatty acids; Nursing
• Online Access: https://scholarsarchive.byu.edu/etd/161; https://scholarsarchive.byu.edu/cgi/viewcontent.cgi?article=1160&context=etd

Purpose: To 1) critically appraise available randomized controlled trials (RTCs) addressing the efficacy of long-chain ω-3 fatty acids as a secondary prevention agent of hypertriglyceridemia, and 2) make recommendations for clinical practice. Data Sources: All RCTs identified from several databases from 1993-2003 were reviewed by two independent reviewers who extracted data from each study and used the previously tested Boyack and Lookinland Methodological Quality Index (MQI) to determine study quality. Results: Ten studies reported long-chain ω-3 fatty acids to be effective in the treatment of hypertriglyceridemia. The average decrease in triglycerides (TG) was 29%, total cholesterol (TC) 11.6%, very low density lipoprotein (VLDL) 30.2%, and low-density lipoprotein (LDL) 32.5%. One study found LDLs to increase by 25%. The average increase in high-density lipoprotein (HDL) was 10%. The overall average MQI score was 36% (26%-54%). Many of the RCTs had serious shortcomings including short duration, lack of a power analysis, no intention to treat analysis, no report of blind assessment of outcome, and lack of dietary control as a confounding variable. Conclusions/Implications: Overall study methodology was weak. Although the evidence supporting the use of long-chain ω-3 fatty acids in the secondary prevention of hypertriglyceridemia is reasonably strong, until there are larger RCTs of stronger methodological quality, it is not recommended to treat hypertriglyceridemia with ω-3 fatty acid supplementation in lieu of lipid lowering medications.