human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: High doses of n-3 PUFA found in fish oils can reduce the circulating concentration of triacylglycerol ( TG ) , which may contribute to the positive impact of these fatty acids on the risk of CVD . The present study aim ed to establish the differential impact of EPA and docosahexaenoic ( DHA ) on plasma lipids and apo in adults . Forty-two normolipidaemic adult subjects completed a double-blind placebo controlled parallel study , receiving an EPA-rich oil ( 4.8 g EPA/d ) , DHA-rich oil ( 4.9 g DHA/d ) or olive oil as control , for a period of 4 weeks . No effects of treatment on total cholesterol , LDL-cholesterol or HDL-cholesterol were evident . There was a significant 22 % reduction in TG level relative to the control value following the DHA treatment ( P=0.032 ) , with the 15 % decrease in the EPA group failing to reach significance ( P=0.258 ) . There were no significant inter-group differences in response to treatment for plasma apoA1 , -C3 or -E levels , although a significant 15 % within-group increase in apoE was evident in the EPA ( P=0.006 ) and DHA ( P=0.003 ) groups . In addition , a within-group decrease in the apoA1:HDL-cholesterol ratio was observed in the DHA group , suggesting a positive impact of DHA on HDL particle size . The DHA intervention result ed in a significant increase in the proportion of EPA P=0.000 and DHA P=0.000 in plasma phospholipids , whilst significant increases in EPA P=0.000 and docosapentaenoic acid P=0.002 , but not DHA P=0.193 , were evident following EPA supplementation ( P<0.05 ) . Our present results indicate that DHA may be more efficacious than EPA in improving the plasma lipid profile BACKGROUND Regular consumption of n-3 fatty acids of marine origin can improve serum lipids and reduce cardiovascular risk . OBJECTIVE This study aim ed to determine whether eicosapentaenoic ( EPA ) and docosahexaenoic ( DHA ) acids have differential effects on serum lipids and lipoproteins , glucose , and insulin in humans . DESIGN In a double-blind , placebo-controlled trial of parallel design , 59 overweight , nonsmoking , mildly hyperlipidemic men were r and omly assigned to receive 4 g purified EPA , DHA , or olive oil ( placebo ) daily while continuing their usual diets for 6 wk . RESULTS Fifty-six men aged 48.8 + /- 1.1 y completed the study . Relative to those in the olive oil group , triacylglycerols fell by 0.45 + /- 0.15 mmol/L ( approximately 20 % ; P = 0.003 ) in the DHA group and by 0.37 + /- 0.14 mmol/L ( approximately 18 % ; P = 0.012 ) in the EPA group . Neither EPA nor DHA had any effect on total cholesterol . LDL , HDL , and HDL(2 ) cholesterol were not affected significantly by EPA , but HDL(3 ) cholesterol decreased significantly ( 6.7 % ; P = 0.032 ) . Although HDL cholesterol was not significantly increased by DHA ( 3 . 1 % ) , HDL(2 ) cholesterol increased by approximately 29 % ( P = 0.004 ) . DHA increased LDL cholesterol by 8 % ( P = 0.019 ) . Adjusted LDL particle size increased by 0.25 + /- 0.08 nm ( P = 0.002 ) with DHA but not with EPA . EPA supplementation increased plasma and platelet phospholipid EPA but reduced  DHA . DHA supplementation increased DHA and EPA in plasma and platelet phospholipids . Both EPA and DHA increased fasting insulin significantly .  EPA , but not DHA , tended to increase fasting glucose , but not significantly so . CONCLUSIONS EPA and DHA had differential effects on lipids , fatty acids , and glucose metabolism in overweight men with mild hyperlipidemia BACKGROUND n-3 Fatty acids lower blood pressure , improve lipids , and benefit other cardiovascular disease risk factors . Effects on glycemia in patients with type 2 diabetes are uncertain . OBJECTIVE We determined whether purified eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) have differential effects on glycemic control , including insulin sensitivity and stimulated insulin secretion ; 24-h ambulatory blood pressure ; and serum lipids in type 2 diabetic patients with treated hypertension . DESIGN In a double-blind , placebo-controlled trial of parallel design , 59 subjects were r and omly assigned to consume 4 g EPA , DHA , or olive oil/d for 6 wk while continuing to consume their usual diet . RESULTS Thirty-nine men and 12 postmenopausal women with a mean ( + /- SE ) age of 61.2 + /- 1.2 y completed the study . In comparison with the change from baseline in fasting glucose in the olive oil group , fasting glucose in the EPA and DHA groups increased 1.40 + /- 0.29 mmol/L ( P = 0.002 ) and 0.98 + /- 0.29 mmol/L ( P = 0.002 ) , respectively . Neither EPA nor DHA had significant effects on glycated hemoglobin , fasting insulin or C-peptide , insulin sensitivity or secretion , or blood pressure . Serum triacylglycerols in the EPA and DHA groups decreased 19 % ( P = 0.022 ) and 15 % ( P = 0.022 ) , respectively . There were no significant changes in serum total , LDL , or HDL cholesterol , although HDL(2 ) cholesterol in the EPA and DHA groups increased 16 % ( P = 0.026 ) and 12 % ( P = 0.05 ) , respectively . HDL(3 ) cholesterol decreased 11 % ( P = 0.026 ) with EPA supplementation . CONCLUSIONS EPA and DHA had similar benefits on lipids but adverse effects on short-term glycemic control in hypertensive diabetic patients . The overall implication s for cardiovascular disease require long-term evaluation Objective —A large-scale , prospect i ve , r and omized clinical trial has recently revealed that the addition of highly purified eicosapentaenoic acid ( EPA ) to low-dose statin therapy significantly reduces the incidence of major coronary events . Here we investigated in vivo and in vitro effect of EPA on monocyte adhesion to endothelial cells and adhesion molecules . Methods and Results —A new en face immunohistochemistry of endothelial surface in combination with confocal microscopy revealed marked reduction of lipopolysaccharide (LPS)-induced monocyte adhesion to the aortic endothelium in parallel with the suppression of vascular cell adhesion molecule 1 ( VCAM-1 ) and nuclear translocation of nuclear factor-&kgr;B p65 in EPA-treated mice relative to vehicle-treated groups . In an in vitro adhesion assay system under physiological flow conditions , EPA inhibited LPS-induced monocyte adhesion and endothelial adhesion molecules . We found significant decrease in plasma concentrations of soluble intercellular adhesion molecule 1 ( sICAM-1 ) and sVCAM-1 in patients with the metabolic syndrome after a 3-month administration of highly purified EPA ( 1.8 g daily ) . Multivariate regression analysis revealed that EPA administration is the only independent determinant of sICAM-1 and sVCAM-1 . Conclusions —This study provides evidence that EPA inhibits monocyte adhesion to endothelial cells in parallel with the suppression of endothelial adhesion molecules in vivo and in vitro BACKGROUND Although some reports have indicated that acute phase proteins such as C-reactive protein ( CRP ) and serum amyloid A ( SAA ) can predict the prognosis in patients with acute coronary syndrome , the value of these markers in patients with stable coronary artery disease ( CAD ) still remains obscure . Therefore , our aim was to determine the prognostic value of inflammatory markers in patients with stable coronary artery disease . METHODS AND RESULTS We conducted a prospect i ve cohort study in 140 consecutive patients with stable coronary artery disease who had at least one coronary stenosis more than 50 % in diameter seen on diagnostic coronary angiography ( CAG ) .  We determined serum levels of the SAA/LDL complex as a new marker in addition to CRP and SAA .  Serum levels of the SAA/LDL complex  were measured by a s and wich enzyme-linked immunosorbent assay ( ELISA ) . End-points were defined as cardiac death , myocardial infa rct ion , cerebral infa rct ion , and coronary revascularization . End-point events occurred in 21 patients ( 2 death from myocardial infa rct ion , 2 cerebral infa rct ion , and 17 revascularization ) . Age ( year ) ( OR = 1.14 , CI : 1.05 - 1.25 ) , diabetes mellitus ( OR = 3.50 , CI : 1.08 - 11.40 ) , triglyceride ( 10mg/dl ) ( OR = 1.12 , CI : 1.01 - 1.23 ) and SAA/LDL complex ( 10 microg/ml ) ( OR = 2.32 , CI : 1.05 - 4.70 ) were independently related to the events . A reconstitution experiment suggested that the SAA/LDL complex is derived by oxidative interaction between SAA and lipoproteins . CONCLUSIONS The SAA/LDL complex reflects intravascular inflammation directly and can be a new marker more sensitive than CRP or SAA for prediction of prognosis in patients with stable coronary artery disease Consumption of fish or fish oils rich in the n-3 long chain PUFA EPA and DHA may improve multiple risk factors for CVD . The objective of this study was to determine whether regular consumption of foods enriched with n-3 long-chain PUFA can improve n-3 long-chain PUFA status ( erythrocytes ) and cardiovascular health .  Overweight volunteers with high levels of triacylglycerols ( TG ; > 1.6 mmol/l ) were enrolled in a 6-month dietary intervention trial conducted in Adelaide ( n 47 ) and Perth ( n 39 ) , and r and omised to consume control foods or n-3-enriched foods  to achieve an EPA + DHA intake of 1 g/d . Test foods were substituted for equivalent foods in their regular diet .  Erythrocyte fatty acids , plasma TG and other CVD risk factors were monitored at 0 , 3 and 6 months . There were no significant differences between groups for blood pressure , arterial compliance , glucose , insulin , lipids , C-reactive protein ( CRP ) or urinary 11-dehydro-thromboxane B2 ( TXB2 ) over 6 months , even though regular consumption of n-3-enriched foods increased  EPA + DHA intake from 0.2 to 1.0 g/d . However , the n-3 long-chain PUFA content of erythrocytes increased by 35 and 53 % at 3 and 6 months , respectively , in subjects consuming the n-3-enriched foods . These increases were positively associated with measures of arterial compliance and negatively associated with serum CRP and urinary 11-dehydro-TXB2 excretion . Sustainable increases in dietary intakes and erythrocyte levels of n-3 long-chain PUFA can be achieved through regular consumption of suitably enriched processed foods . Such increases may be associated with reduced CV risk Subjects with the metabolic syndrome ( MetS ) have enhanced oxidative stress and inflammation . Dietary fat quality has been proposed to be implicated in these conditions . We investigated the impact of four diets distinct in fat quantity and quality on 8-iso-PGF2α ( a major F2-isoprostane and oxidative stress indicator ) , 15-keto-13,14-dihydro-PGF2α ( 15-keto-dihydro-PGF2α , a major PGF2α metabolite and marker of cyclooxygenase-mediated inflammation ) and C-reactive protein ( CRP ) . In a 12-week parallel multicentre dietary intervention study ( LIPGENE ) , 417 volunteers with the MetS were r and omly assigned to one of the four diets : two high-fat diets ( 38 % energy ( % E ) ) rich in SFA or MUFA and two low-fat high-complex carbohydrate diets ( 28 % E ) with ( LFHCC n-3 ) or without ( LFHCC ) 1·24 g/d of very long chain n-3 fatty acid supplementation . Urinary levels of 8-iso-PGF2α and 15-keto-dihydro-PGF2α were determined by RIA and adjusted for urinary creatinine levels . Serum concentration of CRP was measured by ELISA . Neither concentrations of 8-iso-PG 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: High doses of n-3 PUFA found in fish oils can reduce the circulating concentration of triacylglycerol ( TG ) , which may contribute to the positive impact of these fatty acids on the risk of CVD . The present study aim ed to establish the differential impact of EPA and docosahexaenoic ( DHA ) on plasma lipids and apo in adults . Forty-two normolipidaemic adult subjects completed a double-blind placebo controlled parallel study , receiving an EPA-rich oil ( 4.8 g EPA/d ) , DHA-rich oil ( 4.9 g DHA/d ) or olive oil as control , for a period of 4 weeks . No effects of treatment on total cholesterol , LDL-cholesterol or HDL-cholesterol were evident . There was a significant 22 % reduction in TG level relative to the control value following the DHA treatment ( P=0.032 ) , with the 15 % decrease in the EPA group failing to reach significance ( P=0.258 ) . There were no significant inter-group differences in response to treatment for plasma apoA1 , -C3 or -E levels , although a significant 15 % within-group increase in apoE was evident in the EPA ( P=0.006 ) and DHA ( P=0.003 ) groups . In addition , a within-group decrease in the apoA1:HDL-cholesterol ratio was observed in the DHA group , suggesting a positive impact of DHA on HDL particle size . The DHA intervention result ed in a significant increase in the proportion of EPA P=0.000 and DHA P=0.000 in plasma phospholipids , whilst significant increases in EPA P=0.000 and docosapentaenoic acid P=0.002 , but not DHA P=0.193 , were evident following EPA supplementation ( P<0.05 ) . Our present results indicate that DHA may be more efficacious than EPA in improving the plasma lipid profile BACKGROUND Regular consumption of n-3 fatty acids of marine origin can improve serum lipids and reduce cardiovascular risk . OBJECTIVE This study aim ed to determine whether eicosapentaenoic ( EPA ) and docosahexaenoic ( DHA ) acids have differential effects on serum lipids and lipoproteins , glucose , and insulin in humans . DESIGN In a double-blind , placebo-controlled trial of parallel design , 59 overweight , nonsmoking , mildly hyperlipidemic men were r and omly assigned to receive 4 g purified EPA , DHA , or olive oil ( placebo ) daily while continuing their usual diets for 6 wk . RESULTS Fifty-six men aged 48.8 + /- 1.1 y completed the study . Relative to those in the olive oil group , triacylglycerols fell by 0.45 + /- 0.15 mmol/L ( approximately 20 % ; P = 0.003 ) in the DHA group and by 0.37 + /- 0.14 mmol/L ( approximately 18 % ; P = 0.012 ) in the EPA group . Neither EPA nor DHA had any effect on total cholesterol . LDL , HDL , and HDL(2 ) cholesterol were not affected significantly by EPA , but HDL(3 ) cholesterol decreased significantly ( 6.7 % ; P = 0.032 ) . Although HDL cholesterol was not significantly increased by DHA ( 3 . 1 % ) , HDL(2 ) cholesterol increased by approximately 29 % ( P = 0.004 ) . DHA increased LDL cholesterol by 8 % ( P = 0.019 ) . Adjusted LDL particle size increased by 0.25 + /- 0.08 nm ( P = 0.002 ) with DHA but not with EPA . EPA supplementation increased plasma and platelet phospholipid EPA but reduced  DHA . DHA supplementation increased DHA and EPA in plasma and platelet phospholipids . Both EPA and DHA increased fasting insulin significantly .  EPA , but not DHA , tended to increase fasting glucose , but not significantly so . CONCLUSIONS EPA and DHA had differential effects on lipids , fatty acids , and glucose metabolism in overweight men with mild hyperlipidemia BACKGROUND n-3 Fatty acids lower blood pressure , improve lipids , and benefit other cardiovascular disease risk factors . Effects on glycemia in patients with type 2 diabetes are uncertain . OBJECTIVE We determined whether purified eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) have differential effects on glycemic control , including insulin sensitivity and stimulated insulin secretion ; 24-h ambulatory blood pressure ; and serum lipids in type 2 diabetic patients with treated hypertension . DESIGN In a double-blind , placebo-controlled trial of parallel design , 59 subjects were r and omly assigned to consume 4 g EPA , DHA , or olive oil/d for 6 wk while continuing to consume their usual diet . RESULTS Thirty-nine men and 12 postmenopausal women with a mean ( + /- SE ) age of 61.2 + /- 1.2 y completed the study . In comparison with the change from baseline in fasting glucose in the olive oil group , fasting glucose in the EPA and DHA groups increased 1.40 + /- 0.29 mmol/L ( P = 0.002 ) and 0.98 + /- 0.29 mmol/L ( P = 0.002 ) , respectively . Neither EPA nor DHA had significant effects on glycated hemoglobin , fasting insulin or C-peptide , insulin sensitivity or secretion , or blood pressure . Serum triacylglycerols in the EPA and DHA groups decreased 19 % ( P = 0.022 ) and 15 % ( P = 0.022 ) , respectively . There were no significant changes in serum total , LDL , or HDL cholesterol , although HDL(2 ) cholesterol in the EPA and DHA groups increased 16 % ( P = 0.026 ) and 12 % ( P = 0.05 ) , respectively . HDL(3 ) cholesterol decreased 11 % ( P = 0.026 ) with EPA supplementation . CONCLUSIONS EPA and DHA had similar benefits on lipids but adverse effects on short-term glycemic control in hypertensive diabetic patients . The overall implication s for cardiovascular disease require long-term evaluation Objective —A large-scale , prospect i ve , r and omized clinical trial has recently revealed that the addition of highly purified eicosapentaenoic acid ( EPA ) to low-dose statin therapy significantly reduces the incidence of major coronary events . Here we investigated in vivo and in vitro effect of EPA on monocyte adhesion to endothelial cells and adhesion molecules . Methods and Results —A new en face immunohistochemistry of endothelial surface in combination with confocal microscopy revealed marked reduction of lipopolysaccharide (LPS)-induced monocyte adhesion to the aortic endothelium in parallel with the suppression of vascular cell adhesion molecule 1 ( VCAM-1 ) and nuclear translocation of nuclear factor-&kgr;B p65 in EPA-treated mice relative to vehicle-treated groups . In an in vitro adhesion assay system under physiological flow conditions , EPA inhibited LPS-induced monocyte adhesion and endothelial adhesion molecules . We found significant decrease in plasma concentrations of soluble intercellular adhesion molecule 1 ( sICAM-1 ) and sVCAM-1 in patients with the metabolic syndrome after a 3-month administration of highly purified EPA ( 1.8 g daily ) . Multivariate regression analysis revealed that EPA administration is the only independent determinant of sICAM-1 and sVCAM-1 . Conclusions —This study provides evidence that EPA inhibits monocyte adhesion to endothelial cells in parallel with the suppression of endothelial adhesion molecules in vivo and in vitro BACKGROUND Although some reports have indicated that acute phase proteins such as C-reactive protein ( CRP ) and serum amyloid A ( SAA ) can predict the prognosis in patients with acute coronary syndrome , the value of these markers in patients with stable coronary artery disease ( CAD ) still remains obscure . Therefore , our aim was to determine the prognostic value of inflammatory markers in patients with stable coronary artery disease . METHODS AND RESULTS We conducted a prospect i ve cohort study in 140 consecutive patients with stable coronary artery disease who had at least one coronary stenosis more than 50 % in diameter seen on diagnostic coronary angiography ( CAG ) .  We determined serum levels of the SAA/LDL complex as a new marker in addition to CRP and SAA .  Serum levels of the SAA/LDL complex  were measured by a s and wich enzyme-linked immunosorbent assay ( ELISA ) . End-points were defined as cardiac death , myocardial infa rct ion , cerebral infa rct ion , and coronary revascularization . End-point events occurred in 21 patients ( 2 death from myocardial infa rct ion , 2 cerebral infa rct ion , and 17 revascularization ) . Age ( year ) ( OR = 1.14 , CI : 1.05 - 1.25 ) , diabetes mellitus ( OR = 3.50 , CI : 1.08 - 11.40 ) , triglyceride ( 10mg/dl ) ( OR = 1.12 , CI : 1.01 - 1.23 ) and SAA/LDL complex ( 10 microg/ml ) ( OR = 2.32 , CI : 1.05 - 4.70 ) were independently related to the events . A reconstitution experiment suggested that the SAA/LDL complex is derived by oxidative interaction between SAA and lipoproteins . CONCLUSIONS The SAA/LDL complex reflects intravascular inflammation directly and can be a new marker more sensitive than CRP or SAA for prediction of prognosis in patients with stable coronary artery disease Consumption of fish or fish oils rich in the n-3 long chain PUFA EPA and DHA may improve multiple risk factors for CVD . The objective of this study was to determine whether regular consumption of foods enriched with n-3 long-chain PUFA can improve n-3 long-chain PUFA status ( erythrocytes ) and cardiovascular health .  Overweight volunteers with high levels of triacylglycerols ( TG ; > 1.6 mmol/l ) were enrolled in a 6-month dietary intervention trial conducted in Adelaide ( n 47 ) and Perth ( n 39 ) , and r and omised to consume control foods or n-3-enriched foods  to achieve an EPA + DHA intake of 1 g/d . Test foods were substituted for equivalent foods in their regular diet .  Erythrocyte fatty acids , plasma TG and other CVD risk factors were monitored at 0 , 3 and 6 months . There were no significant differences between groups for blood pressure , arterial compliance , glucose , insulin , lipids , C-reactive protein ( CRP ) or urinary 11-dehydro-thromboxane B2 ( TXB2 ) over 6 months , even though regular consumption of n-3-enriched foods increased  EPA + DHA intake from 0.2 to 1.0 g/d . However , the n-3 long-chain PUFA content of erythrocytes increased by 35 and 53 % at 3 and 6 months , respectively , in subjects consuming the n-3-enriched foods . These increases were positively associated with measures of arterial compliance and negatively associated with serum CRP and urinary 11-dehydro-TXB2 excretion . Sustainable increases in dietary intakes and erythrocyte levels of n-3 long-chain PUFA can be achieved through regular consumption of suitably enriched processed foods . Such increases may be associated with reduced CV risk Subjects with the metabolic syndrome ( MetS ) have enhanced oxidative stress and inflammation . Dietary fat quality has been proposed to be implicated in these conditions . We investigated the impact of four diets distinct in fat quantity and quality on 8-iso-PGF2α ( a major F2-isoprostane and oxidative stress indicator ) , 15-keto-13,14-dihydro-PGF2α ( 15-keto-dihydro-PGF2α , a major PGF2α metabolite and marker of cyclooxygenase-mediated inflammation ) and C-reactive protein ( CRP ) . In a 12-week parallel multicentre dietary intervention study ( LIPGENE ) , 417 volunteers with the MetS were r and omly assigned to one of the four diets : two high-fat diets ( 38 % energy ( % E ) ) rich in SFA or MUFA and two low-fat high-complex carbohydrate diets ( 28 % E ) with ( LFHCC n-3 ) or without ( LFHCC ) 1·24 g/d of very long chain n-3 fatty acid supplementation . Urinary levels of 8-iso-PGF2α and 15-keto-dihydro-PGF2α were determined by RIA and adjusted for urinary creatinine levels . Serum concentration of CRP was measured by ELISA . Neither concentrations of 8-iso-PG 
    Output:
    