Association of Improvement of HDL Metabolism and Eicosapentaenoic Acid with Prevention of Coronary Artery Disease

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K09045
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Epidemiology and preventive medicine
• Research Institution: Nihon University
• Principal Investigator: TANI Shigemasa 日本大学, 医学部, 准教授 (30451347)
• Research Collaborator: HIRAYAMA Atsushi 日本大学, 医学部, 教授 (50459880)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: エイコサペンタエン酸 / 多価不飽和脂肪酸 / 冠動脈疾患 / HDLコレステロール

Outline of Final Research Achievements

The following research results were obtained to demonstrate the beneficial effect of EPA on HDL metabolism. 1) Observational study: The index of HDL particle diameter was taken as the HDL-C / apoA-1 ratio in 640 cases with risk factors of coronary artery disease (CAD), and the relationship between serum EPA and DHA levels was examined. The HDL-C / apoA-1 ratio was an independent negative indicator of DHA level. Further examination of the 479 cases that could be followed after 6 months showed that the increase in DHA level was an independent predictor of HDL particle miniaturization. However, the above phenomenon was not observed in EPA.
2) Randomized study: EPA was administered to patients with stable CAD, and a decrease in small HDL particles and an increase in large HDL particles was observed. Therefore, we demonstrated that not only EPA but also n-3 polyunsaturated fatty acids improve HDL metabolism and have a preventive effect on CAD.

Free Research Field

予防医学

Academic Significance and Societal Importance of the Research Achievements

EPA の抗動脈硬化作用として臨床的にHDL-C 代謝に焦点を当てた報告は少ない。近年HDL-C を増加させる創薬（CETP 阻害薬）の有効性を検証する試みが相次いだが、冠動脈疾患発症抑制効果は認められなかった。その要因として血清HDL-C 値を増加させるだけではHDL-C の主なる抗動脈硬化作用であるコレステロール逆転送系の活性化、すなわちHDL-Cの機能改善には結びつかなかったことにある。本研究は魚摂取量の多い日本の食文化がHDL-C の機能を向上させることによって冠動脈疾患の抑制に大きく寄与していることの一端を示した。そして健康医学上、魚摂取の重要性の啓蒙に大きく貢献していると考える。