Evaluation of the Effect of Fish Oil Alone and in Combination with a P | DMSO – Dove Medical Press

Usharani Pingali, 1 Chandrasekhar Nutalapati, 1 Vijay Sravanthi Illendulla 2

1Department of Clinical Pharmacology & Therapeutics, Nizams Institute of Medical Sciences, Hyderabad, Telangana, 500082, India; 2Govt. Ayurvedic Dispensary, Primary Health Center Gummadidala, Sangareddy, Telangana, 502313, India

Correspondence: Usharani Pingali Department of Clinical Pharmacology & Therapeutics, Nizams Institute of Medical Sciences, Hyderabad 500082, Telangana, India Tel +91 9849574143 Email ushapingali@yahoo.com

Purpose: This study was conducted to evaluate the effectiveness of fish oil alone and with an adjunct, a proprietary chromium complex (PCC), on cardiovascular parameters endothelial dysfunction, lipid profile, systemic inflammation and glycosylated hemoglobin in a 12-week randomized, double-blind, placebo-controlled clinical study in type 2 diabetes mellitus subjects. Patients and Methods: In this randomized, double-blind, parallel group study, 59 subjects in three groups completed the study: Group A, fish oil 2000 mg; Group B, fish oil 2000 mg + PCC 10 mg (200 g of Cr 3+); and Group C, fish oil 2000 mg + PCC 20 mg (400 g of Cr 3+) daily for 12 weeks (2000 mg of fish oil contained 600 mg of eicosapentaenoic acid [EPA] and 400 mg of docosahexaenoic acid [DHA], the omega-3 fatty acids). Endothelial function, by estimating reflection index (RI), biomarkers of oxidative stress (nitric oxide [NO], malondialdehyde [MDA], glutathione [GSH]) and inflammatory biomarkers (high-sensitivity C-reactive protein [hsCRP], intercellular adhesion molecule-1 [ICAM-1], vascular cell adhesion molecule-1 [VCAM-1], endothelin-1) were evaluated at baseline, and 4 and 12 weeks. Lipid profile, platelet aggregation and glycosylated hemoglobin [HbA1c) were tested at baseline and 12 weeks. Any reported adverse drug reactions were recorded. Statistical analysis was performed using GraphPad Prism 8. Results: The present study shows that fish oil by itself, at a dose of 2000 mg (600 mg of EPA + 400 mg of DHA) per day, led to significant, but only modest, improvement in cardiovascular parameters (RI from 2.38 0.75 to 3.92 0.60, MDA from 3.77 0.16 to 3.74 0.16 nM/mL, NO from 30.60 3.18 to 32.12 3.40 M/L, GSH from 568.93 5.91 to 583.95 6.53 M/L; p 0.0001), including triglyceride levels. However, when PCC was added to fish oil, especially at the 20 mg dose, there were highly significant improvements in all the parameters tested (RI from 2.04 0.79 to 8.73 1.36, MDA from 3.67 0.39 to 2.89 0.34 nM/mL, NO from 28.98 2.93 to 40.01 2.53 M/L, GSH from 553.82 8.18 to 677.99 10.19 M/L; p 0.0001), including the lipid profile. It is noteworthy that the triglycerides were decreased significantly by addition of 20 mg of PCC although the dose of fish oil was only 2 g/day and the baseline triglyceride levels were only about 200 mg/dL. Fish oil alone did not significantly decrease the HbA1c, whereas the addition of 20 mg of PCC did. Conclusion: Addition of PCC, especially at 20 mg dose, significantly improves the efficacy of fish oil in addressing cardiovascular risk factors compared to fish oil given alone.

Keywords: fish oil, Crominex, diabetes mellitus, omega-3 fatty acids, trivalent chromium, Cr3+

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Evaluation of the Effect of Fish Oil Alone and in Combination with a P | DMSO - Dove Medical Press