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Primary Chylomicronemia in Patients with Severe Familial Hypertriglyceridemia Responds to Long-Term Treatment with (n-3) Fatty Acids¹

Medical Department II, Klinikum Grosshadern, University of Munich, D-81366 Munich, Germany

Because it disturbs microcirculation, chylomicronemia can cause severe clinical complications such as acute pancreatitis. Dietary measures are very important in the prevention and treatment of this condition. Dietary supplementation with (n-3) fatty acids has been shown to be of benefit in short-term treatment of chylomicronemia. To evaluate the long-term efficacy of (n-3) fatty acids we added 2.16 or 4.32 g/d (for 3 mo) and 3.24 g/d (for a further 8 mo after 1 mo of no treatment (n-3) fatty acids to the diet of eight patients with primary chylomicronemia. Serum triglycerides decreased significantly from 15.0 ± 2.5 to 9.9 ± 2.8 mmol/L (P < 0.01) after 11 mo of treatment, and VLDL triglycerides decreased from 12.3 ± 2.8 to 9.0 ± 2.4 mmol/L (P < 0.01), resulting in a significant decrease of plasma viscosity from 1.56 ± 0.17 mPa·s to 1.47 ± 0.12 mPa·s (P < 0.01). Total cholesterol, HDL and LDL cholesterol as well as lipoprotein (a) and fibrinogen concentrations were not affected by fish oil treatment. The presence of chylomicrons and chylomicron remnants (apolipoprotein B 48 concentration in the lipoprotein fraction with a density lower than 1.006 kg/L) was significantly reduced from 4.82 ± 1.08 to 1.06 ± 0.38 mg/L (P < 0.01). Body weight increased significantly from 71.0 ± 4.6 kg to 75.2 ± 5.3 kg after 11 mo of treatment with (n-3) fatty acids. These data indicate that despite an increase in body weight, long-term supplementation of a diet with (n-3) fatty acids results in a persistent decrease of serum triglyceride concentrations, a pronounced reduction in the number of chylomicrons present in the fasting state, and an improvement in plasma viscosity.

KEY WORDS: • (n-3) fatty acids • humans • primary chylomicronemia • plasma viscosity • hypertriglyceridemia

¹ The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked "advertisement" in accordance with 18 USC section 1734 solely to indicate this fact.

² To whom correspondence should be addressed.

Manuscript received 3 August 1994. Revision accepted 29 November 1994.