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Open Access Highly Accessed Opinion

Recent findings on the health effects of omega-3 fatty acids and statins, and their interactions: do statins inhibit omega-3?

Michel de Lorgeril1*, Patricia Salen1, Pascal Defaye2 and Mikael Rabaeus3

Author Affiliations

1 Laboratoire Cœur et Nutrition, TIMC-IMAG CNRS 5525, Université Joseph Fourier, Faculté de Médecine de Grenoble, 38054 La Tronche, France

2 Service de Cardiologie, Hôpital Universitaire Nord, 38054 La Tronche, France

3 Clinique La Prairie, Chemin de la Prairie 2-10, 1815 Clarens, Montreux, Switzerland

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BMC Medicine 2013, 11:5  doi:10.1186/1741-7015-11-5

Published: 4 January 2013

Abstract

Early randomized controlled trials (RCTs) demonstrated the health benefits of omega-3 fatty acids (n-3), whereas recent RCTs were negative. We now address the issue, focusing on the temporal changes having occurred: most patients in recent RCTs are no longer n-3 deficient and the vast majority are now treated with statins. Recent RCTs testing n-3 against arrhythmias suggest that n-3 reduce the risk only in patients not taking a statin. Other recent RCTs in secondary prevention were negative although, in a post-hoc analysis separating statin users and non-users, non-significant protection of n-3 was observed among statin non-users whereas statin users had no effect. Recent RCTs testing statins - after the implementation of the New Clinical Trial Regulation in 2007 - are negative (or flawed) suggesting that the lack of effect of n-3 cannot be attributed to a parallel protection by statins. Finally, statins favor the metabolism of omega-6 fatty acids (n-6), which in turn inhibits n-3 and, contrary to n-3, they increase insulin resistance and the risk of diabetes. Thus, n-3 and statins are counteractive at several levels and statins appear to inhibit n-3.

Keywords:
omega-3 fatty acids; statins; ischemic heart disease; myocardial infarction; randomized clinical trials; epidemiology; mitochondria; insulin resistance; diabetes; n-6 fatty acids