N-3 FATTY-ACIDS DO NOT LEAD TO AN INCREASED DIABETIC RISK IN PATIENTSWITH HYPERLIPIDEMIA AND ABNORMAL GLUCOSE-TOLERANCE

A multicenter, randomized, double-blind, placebo-controlled study eval uated the possible worsening of glycemic control after a moderate dail y intake of n-3 fatty acid ethyl esters in patients with hypertriglyce ridemia with and without glucose intolerance or diabetes. A total of 9 35 patients of both sexes in 63 Italian clinical centers were selected ; 55% had either impaired glucose tolerance or non-insulin-dependent d iabetes mellitus (NIDDM). They received for 2 mo either 1 g n-3 ethyl esters three times a day or a corresponding placebo, followed by 4 mo of either 1 g n-3 ethyl esters twice a day or placebo. In addition to the complete lipid and lipoprotein evaluation, patients with impaired glucose tolerance also underwent an oral-glucose-tolerance test; in pa tients with NIDDM, serum insulin and glycated hemoglobin (Hb A(1c)) co ncentrations were determined. Plasma triacylglycerol concentrations de creased significantly up to 21.53% at 6 mo compared with baseline (dec reased 15% compared with placebo), with a tendency toward a progressiv e reduction with time. There was no evidence for a different response in patients with either NIDDM or impaired glucose tolerance. Among NID DM patients, the triacylglycerol reduction was greater in those with h igh-density-lipoprotein cholesterol less than or equal to 0.91 mmol/L. There was no alteration in the major glycemic indexes: fasting glucos e, Hb A(1c), insulinemia, and oral glucose tolerance in patients with impaired glucose tolerance or NIDDM after treatment with n-3 ethyl est ers. Treatment with a moderate daily dose of n-3 ethyl esters over a p rolonged period of time significantly reduced triacylglycerol concentr ations without any worsening of glucose tolerance in patients with hyp ertriglyceridemia with and without impaired glycemic regulation.