TY - JOUR
T1 - Effects of docosahexanoic acid on metabolic and fat parameters in HIV-infected patients on cART: A randomized, double-blind, placebo-controlled study
AU - Domingo, Pere
AU - Fernández, Irene
AU - Gallego-Escuredo, José Miguel
AU - Torres, Ferran
AU - Gutierrez, M. del Mar
AU - Mateo, Ma Gracia
AU - Villarroya, Joan
AU - Giralt, Marta
AU - Vidal, Francesc
AU - Villarroya, Francesc
AU - Domingo, Joan Carles
PY - 2018/8/1
Y1 - 2018/8/1
N2 - © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism Background: Hypertriglyceridemia is common in HIV-infected patients. Polyunsaturated fatty acids reduce fasting serum triglyceride (TG) levels in HIV-infected patients. It is not known whether docosahexanoic acid (DHA) supplementation can reduce hypertriglyceridemia and modify fat distribution in HIV-infected patients. Methods: We conducted a randomized, double-blind, placebo-controlled trial with 84 antiretroviral-treated patients who had fasting TG levels from 2.26 to 5.65 mmol/l and were randomized to receive DHA or placebo for 48 weeks. TG levels were assessed at baseline, week 4 and every 12 weeks. Body composition was assessed at baseline and at week 48. Registered under ClinicalTrials.gov Identifier no. NCT02005900. Results: Patients receiving DHA had a 43.9% median decline in fasting TG levels at week 4 (IQR: −31% to −56%), compared with −2.9% (−18.6% to 16.5%) in the placebo group (P < 0.0001). DHA levels and decrease in TG at week 4 in the DHA arm correlated significantly (r = 0.7110, P < 0.0001). The median reduction in TG levels in the DHA arm was −43.7% (−32.4% to −57.5%), and in the placebo arm +2.9% (−21.3% to +30.1%) at week 12. The difference remained statistically significant at week 48 (P = 0.0253). LDL cholesterol levels significantly increased at week 4 by 7.1% (IQR: −4.8% to +35.3%) in the DHA arm but not in the placebo group. No significant changes were observed in HDL cholesterol, insulin, and HOMA-IR during the study. Limb fat significantly increased in both arms, without statistically significant differences between groups (P = 0.3889). DHA was well tolerated; only 3 patients experienced treatment-limiting toxicity. Conclusions: Supplementation with DHA reduced fasting TG levels in antiretroviral-treated HIV-infected patients with mild hypertriglyceridemia. DHA was well tolerated with minor GI symptoms. Peripheral fat significantly increased in the DHA group but did not increase significantly compared with placebo.
AB - © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism Background: Hypertriglyceridemia is common in HIV-infected patients. Polyunsaturated fatty acids reduce fasting serum triglyceride (TG) levels in HIV-infected patients. It is not known whether docosahexanoic acid (DHA) supplementation can reduce hypertriglyceridemia and modify fat distribution in HIV-infected patients. Methods: We conducted a randomized, double-blind, placebo-controlled trial with 84 antiretroviral-treated patients who had fasting TG levels from 2.26 to 5.65 mmol/l and were randomized to receive DHA or placebo for 48 weeks. TG levels were assessed at baseline, week 4 and every 12 weeks. Body composition was assessed at baseline and at week 48. Registered under ClinicalTrials.gov Identifier no. NCT02005900. Results: Patients receiving DHA had a 43.9% median decline in fasting TG levels at week 4 (IQR: −31% to −56%), compared with −2.9% (−18.6% to 16.5%) in the placebo group (P < 0.0001). DHA levels and decrease in TG at week 4 in the DHA arm correlated significantly (r = 0.7110, P < 0.0001). The median reduction in TG levels in the DHA arm was −43.7% (−32.4% to −57.5%), and in the placebo arm +2.9% (−21.3% to +30.1%) at week 12. The difference remained statistically significant at week 48 (P = 0.0253). LDL cholesterol levels significantly increased at week 4 by 7.1% (IQR: −4.8% to +35.3%) in the DHA arm but not in the placebo group. No significant changes were observed in HDL cholesterol, insulin, and HOMA-IR during the study. Limb fat significantly increased in both arms, without statistically significant differences between groups (P = 0.3889). DHA was well tolerated; only 3 patients experienced treatment-limiting toxicity. Conclusions: Supplementation with DHA reduced fasting TG levels in antiretroviral-treated HIV-infected patients with mild hypertriglyceridemia. DHA was well tolerated with minor GI symptoms. Peripheral fat significantly increased in the DHA group but did not increase significantly compared with placebo.
KW - Docosahexanoic acid
KW - Insulin resistance
KW - LDL cholesterol
KW - Subcutaneous fat
KW - Total cholesterol
KW - Triglycerides
U2 - 10.1016/j.clnu.2017.05.032
DO - 10.1016/j.clnu.2017.05.032
M3 - Article
VL - 37
SP - 1340
EP - 1347
JO - Clinical Nutrition
JF - Clinical Nutrition
SN - 0261-5614
IS - 4
ER -