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Apo(E) and Fish Oil

Member Forum >> Coronary Disease & Cholesterol Protocol >> Apo(E) and Fish Oil

Ilaine

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Posted: 6/18/2014 7:54:49 PM
Edited: 6/18/2014 8:06:29 PM (2)
 

Does APOE Genotype Modify the Relations Between Serum Lipid and Erythrocyte Omega-3 Fatty Acid Levels?

Abstract

Earlier reports indicated that patients with the apolipoprotein APOE ε4 allele responded to fish oil supplementation with a rise in serum low-density lipoprotein cholesterol (LDL-C) compared to ε3 homozygotes. In this study, we used clinical laboratory data to test the hypothesis that the cross-sectional relation between RBC omega-3 fatty acid status (the Omega-3 Index) and LDL-C was modified by APOE genotype. Data from 136,701 patients were available to compare lipid biomarker levels across Omega-3 Index categories associated with heart disease risk in all APOE genotypes. We found no adverse interactions between APOE genotype and the Omega-3 Index for LDL-C, LDL particle number, apoB, HDL-C, or triglycerides. However, we did find evidence that ε2 homozygotes lack an association between omega-3 status and LDL-C, apoB, and LDL particle number. In summary, we found no evidence for a deleterious relationship between lipid biomarkers and the Omega-3 Index by APOE genotype.

http://ht.ly/urPvo

From the main paper, which is available free and full, "To the point of this paper, there were no unique relationships between atherogenic lipids and omega-3 status associated with the ε4 genotype."

The effects of omega-3 treatment on lipid profiles in patients carrying an ε4 allele was examined in several previous studies, most from the University of Reading, UK. In the first, despite finding no significant effect of genotype on serum lipid responses to fish oil, the authors stated that, “In APOE4 carriers, the hypotriglyceridemic benefits [of fish oil] may be counteracted by a potential proatherogenic shift in the cholesterol profile” [7]. This conclusion was widely construed by many clinicians to mean that APOE4 carriers should not be given fish oil. A follow-up study reported no effect of genotype, but the dose of omega-3 fatty acids was rather low [9]. In the third study [8], normal volunteers (n = 20 for ε3/ε3 vs. n  = 18 for ε3/ε4) were given either 3.7 g/day of DHA or 3.3 g/day of EPA. The latter had no effect on LDL-C in either group, but the former increased LDL-C by 10 % from baseline in the ε4 carriers compared with a 4 % decrease in the reference group. Of note, apoB was not differentially affected by genotype nor was LDL-P raised by DHA [20]. A 2012 study including 88 subjects failed to confirm the adverse DHA effect [10]. There was no APOE genotype interaction for postprandial lipid responses while on a fish oil diet [21] nor did the authors find a genotype interaction for the effect of fish oil on LDL-C. Our findings, and those from the MESA investigators [12], are consistent with the majority view that the relationship between omega-3 fatty acid blood levels and LDL-C is not different in ε4 carriers relative to that in the common wild-type genotype.
Taking a wider view, it is well known that ε4 patients are at higher risk for CHD [5, 17] and for Alzheimer’s disease [22]. Even if the efficacy of fish oil supplements as treatments for CHD is in question [23, 24], several studies have shown that higher omega-3 fatty acid blood levels are associated with decreased risk for all-cause mortality [2528] and dementia [29]. Direct consumption of EPA and DHA (whether from fish oil supplements or oily fish) is by far the most important determinant of the Omega-3 Index [3033]. Their safety profile is strong [34], and thus, their risk/benefit ratio is favorable. Finally, because ε4 carriers may require higher doses of EPA + DHA to raise the Omega-3 Index (as suggested in some [35, 36] but not other [10] studies), patients carrying this allele may be the most likely to benefit from an increased omega-3 fatty acid intake.
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kitchensink

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Posted: 6/19/2014 6:58:32 AM
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Great study - many thanks


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plaquebegone

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Posted: 6/28/2014 6:15:46 PM
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Helpful in making a decision about dosage (I'm a 3/4).  Thanks.
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Turin

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Posted: 8/2/2014 11:38:26 AM
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I'm 3/4 and take 1900mg EPA and 1500mg DPA twice daily.  Doing great.  This winter will be 1 year, so I'll be interested to see my blood work when I have it done in December.  Oh yeah, lp(a) here also.


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cpatr922

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Posted: 2/28/2018 12:25:17 PM
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Very informative, just found out I am E3/E4, will consume higher dosage of fish oils.
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NoMoWheat

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Posted: 1/19/2021 1:39:45 PM
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Wonder if any more recent studies have been done or is this still applicable?


Tags: #APOE,#cholesterol,#Omega3