Article

Reduction in triglyceride level with N-3 polyunsaturated fatty acids in HIV-infected patients taking potent antiretroviral therapy: A randomized prospective study

AP-HP, University Paris-Ile-de-France-Ouest-Versailles, Hôpital Raymond Poincaré, 104 boulevard Raymond Poincaré, 92380 Garches, France.
JAIDS Journal of Acquired Immune Deficiency Syndromes (Impact Factor: 4.39). 03/2007; 44(3):278-85. DOI: 10.1097/QAI.0b013e31802c2f3d
Source: PubMed

ABSTRACT To assess the evolution of triglyceride (TG) levels in HIV-infected patients receiving stable potent antiretroviral therapy treated with N-3 polyunsaturated fatty acids (PUFAs), a prospective double-blind randomized design for a reliable assessment of TG evolution was performed. One hundred twenty-two patients with TG levels >2 g/L and < or =10 g/L after a 4-week diet (baseline TG: 4.5 +/- 1.9 g/L) were randomized for 8 weeks to N-3 PUFAs (2 capsules containing 1 g of fish oil 3 times daily, n = 60), or placebo (1 g of paraffin oil capsules, n = 62). An 8-week open-label phase of N-3 PUFAs followed. Evaluation criteria were TG percent change at week 8, percentage of responders (normalization or > or =20% TG decrease), and safety issues. Ten patients with baseline TG levels >10 g/L were not randomized and received N-3 PUFAs as open treatment. The difference (PUFA - placebo) in TG percent change at week 8 was -24.6% (range: -40.9% to -8.4%; P = 0.0033), the median was -25.5% in the PUFA group versus 1% in the placebo group, and mean TG levels at week 8 were 3.4 +/- 1.8 g/L and 4.8 +/- 3.1 g/L, respectively. TG levels were normalized in 22.4% (PUFA) versus 6.5% (placebo) of patients (P = 0.013) with a > or =20% reduction in 58.6% (PUFA) versus 33.9% (placebo) of patients (P = 0.007). Under the open-label phase of N-3 PUFAs, the decrease in TG levels was sustained at week 16 for patients in the PUFA group (mean TG: 3.4 +/- 1.7 g/L), whereas a 21.2% decrease in TG levels occurred for patients in the placebo group (mean TG: 3.3 +/- 1.4 g/L). No significant differences were observed between groups in the occurrence of adverse events. The median TG change at week 8 was -43.6% (range: Q1-Q3; 95% CI: -66.5% to -4.6%) for patients with baseline TG levels >10 g/L. The difference in mean total cholesterol between groups (PUFA - placebo) at week 8 was -8.5% (P = 0.0117). This study demonstrated the efficacy of PUFAs to lower elevated TG levels in treated HIV-infected hypertriglyceridemic patients. N-3 PUFAs have a good safety profile.

0 Followers
 · 
104 Views
  • Source
    • "O número de pacientes em cada grupo (GI e GC) variou de cinco a 62. Todos os estudos analisaram os pacientes que concluíram a pesquisa, denominados " compleaters " , exceto o estudo de Truchis et al, 16 (2007) que também incluiu análise por intenção de tratar. A perda de seguimento ocorreu em seis estudos. "
    [Show abstract] [Hide abstract]
    ABSTRACT: To analyze the effect of nutritional treatment on metabolic changes caused by the use of antiretroviral therapy in adults with HIV/AIDS. A systematic review of literature was conducted in the PubMed, Lilacs and Cochrane databases, between 1996 and 2010, including crossover and randomized controlled clinical trials performed in adults with HIV/AIDS using antiretroviral therapy and without opportunistic diseases. The intervention of interest was oral nutritional supplementation and/or a change in lifestyle due to specific dietary treatment: dyslipidemia, insulin resistance, lipodystrophy and systemic arterial hypertension. The Jadad scale was used for a qualitative classification of articles. A total of 385 articles were found, of which seven were included. The interventions used in these studies were as follows: diet, diet and physical exercises, diet and supplementation, and only supplementation. Dyslipidemia was the outcome assessed in all studies. Studies that assessed omega-3 supplementation found a significant reduction in triglycerides. The specific diet with omega-3 supplementation showed an increase in HDL-cholesterol. Chrome nicotinate supplementation did not have an effect on dyslipidemia. Changing one's lifestyle, including diet and physical activity, significantly reduced waist circumference, lipodystrophy and systolic blood pressure. Reduction in tryglicerides with omega-3 supplementation was the nutritional intervention with the strongest scientific evidence. Prescribing a specific diet appeared to be the most adequate intervention to increase HDL-cholesterol. Inferences could not be made about the nutritional treatment of total cholesterol, LDL-cholesterol and insulin resistance. Changes in lifestyle can promote an improvement in lipodystrophy and blood pressure.
    Revista de saude publica 07/2012; 46(4):737-46. · 1.22 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: With the introduction of highly active antiretroviral therapy (HAART), metabolic and body composition changes are increasingly observed among HIV-infected patients. These changes are characterized by lipoatrophy of subcutaneous abdominal, extremity and facial fat, increased visceral fat, as well as dyslipidemia and insulin resistance, and have been viewed by many to constitute an acquired lipodystrophy syndrome. The etiology of this syndrome is clearly multifactorial and it is not a homogenous syndrome, but rather exhibits significant heterogeneity depending on environmental, genetic, and treatment factors.
    01/1970: pages 343-358;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduces a hardware design methodology based on Petri nets that is applied to the verification of digital control paths. The main purpose is to design control paths that are modeled and verified formally by means of Petri net techniques. A verified digital system can be implemented in self-timed or in synchronous clocked hardware modules. Finally, timing analysis can be performed by timed Petri nets
    Systems, Man, and Cybernetics, 2001 IEEE International Conference on; 02/2001
Show more