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Background <p>Carotid plaques result from a blockage or narrowing of carotid arteries associated with severe atherosclerotic cardiovascular diseases. We aimed to assess the effect of marine n-3 fatty acid supplementation on carotid plaques among patients with diabetes and whether the effect was modified by genetics.</p> Methods <p>In this 14&#xa0;month double-blind, randomized controlled trial, 415 patients with type 2 diabetes (T2D) were randomly assigned to receive high-dose (3.0&#xa0;g/day) or low-dose (1.5&#xa0;g/day) marine n-3 fatty acids (fish oil) or placebo (refined olive oil). The primary outcome was the prevalence of carotid plaques. Secondary outcomes included changes in NMR-derived lipoprotein subclasses. Genetic interactions with the supplementation were also explored.</p> Results <p>383 participants (92.3%) completed the 14&#xa0;month intervention, and 359 patients (86.5%) completed carotid ultrasound exams. Fish oil supplementation did not significantly reduce the carotid plaque prevalence (P trend = 0.111). Compared to the placebo, the odds ratios (95% CIs) of carotid plaque risk were 1.11 (0.56–2.22) and 0.54 (0.26–1.13) for low-dose and high-dose groups, respectively. Fish oil supplementation also showed no significant effect on the incidence of new carotid plaques (P for trend = 0.304) or the regression of existing plaques (P for trend = 0.390). High-dose intervention significantly reduced remnant cholesterol, LDL-1-triglycerides (TG), HDL-4-TG, and HDL-3-TG. In subgroups by genetic risk, the high-dose intervention significantly reduced carotid plaque risk specifically in patients with a low genetic risk for remnant cholesterol, with no significant benefit observed in those with medium or high genetic risk (P for interaction = 0.008; FDR = 0.056).</p> Conclusion <p>In patients with T2D, 14&#xa0;month marine n-3 fatty acid supplementation does not reduce carotid plaque risk but improves lipoprotein profile. The anti-atherosclerotic effect appeared significant in patients with a low genetic risk of remnant cholesterol, warranting further investigation into personalized nutritional strategies.</p> Trial registration <p>Clinicaltrials.gov NCT03708887.</p>

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Marine n-3 fatty acid treatment for carotid plaques in patients with type 2 diabetes

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月20日

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  • Pan Zhuang,
  • Xiaohui Liu,
  • Wei Jia,
  • Weifang Zheng,
  • Xuzhi Wan,
  • Weiming Chen,
  • Jinping Gu,
  • Yin Li,
  • Xiaochun Lan,
  • Haoyu Li,
  • Wenzhou Tong,
  • Yuqi Wu,
  • Xiangming Wu,
  • Yang Ao,
  • Hao Ye,
  • Fei Wu,
  • Li Zhu,
  • Lange Zhang,
  • Yaoran Li,
  • Denghui Meng,
  • Yimei Tian,
  • Anli Wang,
  • Shanyun Wu,
  • Fanghuan Zhu,
  • Yiju Zhang,
  • Hongbo Shi,
  • Xiaomei Yu,
  • Fan Zhang,
  • Yu Zhang,
  • Jingjing Jiao

摘要

Background

Carotid plaques result from a blockage or narrowing of carotid arteries associated with severe atherosclerotic cardiovascular diseases. We aimed to assess the effect of marine n-3 fatty acid supplementation on carotid plaques among patients with diabetes and whether the effect was modified by genetics.

Methods

In this 14 month double-blind, randomized controlled trial, 415 patients with type 2 diabetes (T2D) were randomly assigned to receive high-dose (3.0 g/day) or low-dose (1.5 g/day) marine n-3 fatty acids (fish oil) or placebo (refined olive oil). The primary outcome was the prevalence of carotid plaques. Secondary outcomes included changes in NMR-derived lipoprotein subclasses. Genetic interactions with the supplementation were also explored.

Results

383 participants (92.3%) completed the 14 month intervention, and 359 patients (86.5%) completed carotid ultrasound exams. Fish oil supplementation did not significantly reduce the carotid plaque prevalence (P trend = 0.111). Compared to the placebo, the odds ratios (95% CIs) of carotid plaque risk were 1.11 (0.56–2.22) and 0.54 (0.26–1.13) for low-dose and high-dose groups, respectively. Fish oil supplementation also showed no significant effect on the incidence of new carotid plaques (P for trend = 0.304) or the regression of existing plaques (P for trend = 0.390). High-dose intervention significantly reduced remnant cholesterol, LDL-1-triglycerides (TG), HDL-4-TG, and HDL-3-TG. In subgroups by genetic risk, the high-dose intervention significantly reduced carotid plaque risk specifically in patients with a low genetic risk for remnant cholesterol, with no significant benefit observed in those with medium or high genetic risk (P for interaction = 0.008; FDR = 0.056).

Conclusion

In patients with T2D, 14 month marine n-3 fatty acid supplementation does not reduce carotid plaque risk but improves lipoprotein profile. The anti-atherosclerotic effect appeared significant in patients with a low genetic risk of remnant cholesterol, warranting further investigation into personalized nutritional strategies.

Trial registration

Clinicaltrials.gov NCT03708887.