Омега-3 полиненасыщенные жирные кислоты в коррекции дислипидемии и снижении остаточного риска сердечно-сосудистых заболеваний

Введение. Назначение статинов является методом профилактики и лечения сердечно-сосудистых заболеваний (ССЗ) с доказанной долгосрочной безопасностью и эффективностью. Монотерапия статинами снижает концентрацию холестерина липопротеидов низкой плотности и общий риск сердечно-сосудистой смертности, однако у пациентов сохраняется резидуальный риск, связанный с повышенным уровнем триглицеридов. Существуют данные, что остаточный риск ССЗ может быть снижен с помощью применения длинноцепочечных ω3 полиненасыщенных жирных кислот (ω3 ПНЖК) − эйкозапентаеновой (EPA 20:5 ω3) и докозагексаеновой (DHA 22:6 ω3). В то же время, в отношении снижения риска развития сердечно-сосудистых событий данные кислоты показали неоднозначные результаты.

Цель. На основании анализа доступной литературы проанализировать причины расхождений в результатах исследований исходов ССЗ и обсудить гетерогенность ответа организма на прием ω3 ПНЖК.

Материалы и методы. В базе данных PubMed проводился поиск информации за последние пять лет по выбранным критериям включения. Информационные запросы включали следующую совокупность ключевых слов: «эйкозапентаеновая кислота, докозагексаеновая кислота, гипертриглицеридемия, сердечно-сосудистый риск».

Результаты. Доза, вид и соотношение используемого сочетания ω3 ПНЖК могут иметь значение в оценке эффекта ω3 ПНЖК в отношении снижения риска развития сердечно-сосудистых событий и смертности. В настоящем обзоре обобщены последние литературные данные о перспективах применения статинов, комбинации EPA+DHA и монорежима EPA в лечении гипертриглицеридемии и снижении риска развития ССЗ. Обсуждается гетерогенность ответа организма на прием ω3 ПНЖК.

Заключение. Несмотря на противоречивость результатов метаанализов эффективности применения комбинаций различных типов ω3 ПНЖК, очевидно, что дальнейшее изучение сочетанного применения EPA и DHA, режима их дозировании и сочетания со статинотерапией сделает их привлекательными для снижения резидуального риска ССЗ.

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