Effects of a Small Quantity of ω-3 Fatty Acids on Cardiovascular Risk Factors in NIDDM: A randomized, prospective, double-blind, controlled study

Lloyd Axelrod; Janice Camuso; Ellen Williams; Kenneth Kleinman; Esperanza Briones; David Schoenfeld

doi:10.2337/diacare.17.1.37

Original Articles

Effects of a Small Quantity of ω-3 Fatty Acids on Cardiovascular Risk Factors in NIDDM: A randomized, prospective, double-blind, controlled study

Lloyd Axelrod, MD,
Janice Camuso, RN,
Ellen Williams, RD,
Kenneth Kleinman, BA,
Esperanza Briones, PHD and
David Schoenfeld, PHD

Diabetes Unit and the Medical Services, Massachusetts General Hospital; and the Department of Medicine, Harvard Medical School Boston, Massachusetts

Address reprint requests to Lloyd Axelrod, MD, Diabetes Unit, Massachusetts General Hospital, Boston, MA 02114.

Diabetes Care 1994 Jan; 17(1): 37-44. https://doi.org/10.2337/diacare.17.1.37

Abstract

OBJECTIVE To study the effects of a low dose of ω-3 fatty acids on platelet function and other cardiovascular risk factors in patients with non-insulin-dependent diabetes mellus (NIDDM).

RESEARCH DESIGN AND METHODS We performed a randomized, prospective, double-blind, controlled study of a low dose of ω-3 fatty acids (2.5 g/day) in 20 ambulatory subjects with NIDDM. Subjects ingested five 1-g fish oil capsules each containing 0.5 g ω-3 fatty acids or five 1-g safflower oil capsules per day for 6 weeks followed by a 6-week washout period.

RESULTS Nine subjects completed the study in each group. Both groups exhibited moderate control of glucose levels; modest elevations in baseline total cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride (TG) levels; and normal blood pressure values. In the fish oil group, plasma ω-3 fatty acid levels increased significantly. Fish oil significantly reduced the slope of the dose-response curves for collagen-induced platelet aggregation to one-third the value observed with safflower oil. No difference was observed in collageninduced production of thromboxane A₂ (TXA₂, measured as the stable derivative TXB₂), or in adenosine-5'-diphosphate- (ADP) induced platelet aggregation or TXA₂ generation. Patients with high initial collagen-induced platelet TXA₂ production showed a significantly larger drop after fish oil than safflower oil. Fish oil significantly reduced TG levels by 44 mg/dl and decreased upright systolic blood pressure (sBP) by 8 mmHg compared with safflower oil. Fish oil caused a significant but small increase in HbA_1c (0.56%) and total cholesterol (20 mg/dl) but had no effect on fasting glucose, high-density lipoprotein cholesterol, or LDL-cholesterol levels.

CONCLUSIONS Small doses of fish oil inhibit platelet aggregation and TXA₂ production, reduce upright sBP and TG levels, and have only a small effect on glucose and cholesterol levels in patients with moderately controlled NIDDM. Small quantities of ω-3 fatty acids or dietary fish are safe and potentially beneficial in NIDDM patients.