“One of the surprising findings of this analysis is that the prescription omega-3 fatty acids containing DHA did not increase LDL cholesterol in studies of people with triglycerides less than 500 mg/dL,” said Skulas-Ray. In prior studies suggesting that DHA-containing agents may increase LDL cholesterol, researchers did not stratify by patient populations, such as those with and without severe hypertriglyceridemia. “The results we reviewed suggest to me that LDL increases proportionally to the degree of triglyceride reduction, not as a result of the prescription agent containing DHA,” she said.
Has she read the MARINE and ANCHOR studies? DHA and EPA both stimulate lipoprotein lipase to break down VLDL to IDL and then LDL---this mechanism saturates between 500 to 1000mg/dl to capacity---the differential arises because EPA can also inhibit hepatic VLDL and TG remnant formation directly by inhibiting VLDL synthetic mechanisms in the liver. This is the reason why quoting Mori and other irrelevant prior art dealing with TG 200-250 range patients as evidence of obviousness is disingenuous and betrays a lack of understanding of the science differentiating DHA and EPA and why MARINE was valid for TG>500mg/dl despite the Mori shenanigans.
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