Changes in hemostasis during treatment of hypertriglyceridemia with a dietrich in monounsaturated and n-3 polyunsaturated fatty acids in comparison with a low-fat diet

High levels of fibrinogen, factor (F) VIIc, plasminogen activator inhibitor -1 (PAI-1), and plasma viscosity are associated with an increased coronary risk. As positive correlations of these parameters with triglycerides have been shown, the increased coronary risk associated with high levels of trig lycerides may be assumed to be due to alterations within the hemostatic sys tem. To reduce the coronary risk to which hypertriglyceridemic patients are exposed, dietary treatment is recommended; the optimal composition of such a diet is, however, a matter of debate. With regard to the effects on hemo stasis, we compared in a sequential approach two diets for treatment of 25 nonobese male patients (age, mean +/-S.D., 40.4 +/-8.7 years) with fasting triglycerides >2.3 mmol/l. The first diet (high fat) was rich in monounsatu rated fatty acids (MUFA) and marine n-3 polyunsaturated fatty acids (PUFA), whereas the second diet (low-fat) was rich in complex carbohydrates and di etary fiber. The high-fat diet induced a significant lowering of FIIc, FIXc , FXc, FVIIc, FVIIa, FXIIa, PAI-1, plasma viscosity, and platelet activity, but led to an increase in fibrinogen, whereas the low-fat diet lowered FXI Ic values and induced a nonsignificant decrease in fibrinogen. Probands on this diet had a slightly higher FVIIa and platelet activity than those on t he high-fat diet. However, as all changes appeared to be within the normal range of each hemostatic parameter, it remains to be clarified whether the likely beneficial effects of the high-fat diet on most hemostatic factors a re outweighed by the small increase in fibrinogen levels. (C) 2001 Elsevier Science Ltd. All rights reserved.