Effects of docosahexanoic acid on metabolic and fat parameters in HIV-infected patients on cART: A randomized, double-blind, placebo-controlled study. Issue 4 (August 2018)

• Record Type: Journal Article
• Authors: Domingo, Pere; Fernández, Irene; Gallego-Escuredo, José Miguel; Torres, Ferran; Gutierrez, M del Mar; Mateo, M Gracia; Villarroya, Joan; Giralt, Marta; Vidal, Francesc; Villarroya, Francesc; Domingo, Joan Carles
• Is Part Of: Clinical nutrition. Volume 37:Issue 4(2018)
• Page Start: 1340
• Page End: 1347
• Publication Date: 2018-08
• Subjects: Triglycerides -- Docosahexanoic acid -- Total cholesterol -- Subcutaneous fat -- LDL cholesterol -- Insulin resistance; Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2017.05.032
• Languages: English
• ISSNs: 0261-5614

Abstract

Summary: Background: Hypertriglyceridemia is common in HIV-infected patients. Polyunsaturated fatty acids reduce fasting serum triglyceride (TG) levels in HIV-infected patients. It is not known whether docosahexanoic acid (DHA) supplementation can reduce hypertriglyceridemia and modify fat distribution in HIV-infected patients. Methods: We conducted a randomized, double-blind, placebo-controlled trial with 84 antiretroviral-treated patients who had fasting TG levels from 2.26 to 5.65 mmol/l and were randomized to receive DHA or placebo for 48 weeks. TG levels were assessed at baseline, week 4 and every 12 weeks. Body composition was assessed at baseline and at week 48. Registered underClinicalTrials.gov Identifier no.NCT02005900 . Results: Patients receiving DHA had a 43.9% median decline in fasting TG levels at week 4 (IQR: −31% to −56%), compared with −2.9% (−18.6% to 16.5%) in the placebo group (P < 0.0001). DHA levels and decrease in TG at week 4 in the DHA arm correlated significantly (r = 0.7110, P < 0.0001). The median reduction in TG levels in the DHA arm was −43.7% (−32.4% to −57.5%), and in the placebo arm +2.9% (−21.3% to +30.1%) at week 12. The difference remained statistically significant at week 48 (P = 0.0253). LDL cholesterol levels significantly increased at week 4 by 7.1% (IQR: −4.8% to +35.3%) in the DHA arm but not in the placebo group. No significant changes were observed in HDL cholesterol, insulin, and HOMA-IR during the study. Limb fat significantly increased in both arms, without statistically significant differences between groups (P = 0.3889). DHA was well tolerated; only 3 patients experienced treatment-limiting toxicity. Conclusions: Supplementation with DHA reduced fasting TG levels in antiretroviral-treated HIV-infected patients with mild hypertriglyceridemia. DHA was well tolerated with minor GI symptoms. Peripheral fat significantly increased in the DHA group but did not increase significantly compared with placebo.