Fish oil supplementation reduces the CERT2 risk score in adults with increased cardiometabolic risk: findings from the MoKaRi trial
Background - Ceramides and phosphatidylcholines, key components of the Coronary Event Risk Test 2 (CERT2), are strong predictors of cardiovascular events beyond low-density lipoprotein cholesterol (LDL-C). Whether dietary strategies targeting lipidomic risk profiles can modify these biomarkers remai...
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| Autori principali: | , , , , , , , , |
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| Natura: | Article (Journal) |
| Lingua: | inglese |
| Pubblicazione: |
24 August 2026
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| In: |
Journal of clinical lipidology
Year: 2026, Pages: 1-23 |
| ISSN: | 1876-4789 |
| DOI: | 10.1016/j.jacl.2026.08.013 |
| Accesso online: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.jacl.2026.08.013 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S1933287426004897 
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| Note sull'autore: | Angelika Witoslawska, MSc., Christine Dawczynski, PhD, Mitja Lääperi, MSc., Reini Hurme, PhD, eMBA, Michael Kiehntopf, PhD, MD, Stefan Lorkowski, PhD, Winfried März, MD, Reijo Laaksonen, MD, FESC, Angela P. Moissl-Blanke PhD |
| Riassunto: | Background - Ceramides and phosphatidylcholines, key components of the Coronary Event Risk Test 2 (CERT2), are strong predictors of cardiovascular events beyond low-density lipoprotein cholesterol (LDL-C). Whether dietary strategies targeting lipidomic risk profiles can modify these biomarkers remains insufficiently explored. - Objective - To investigate whether long-chain n-3 polyunsaturated fatty acid supplementation, within a structured cardioprotective dietary programme, modifies ceramide- and phosphatidylcholine-associated cardiovascular risk in adults at increased cardiometabolic risk in a primary prevention setting. - Methods - The MoKaRi trial was a 20-week, randomised, parallel-group dietary intervention followed by a 20-week follow-up. Adults aged 20-80 years with LDL-C ≥3.0 mmol/L, not receiving lipid-lowering medication, were included. Participants received either personalised cardioprotective menu plans (MP) or identical menu plans supplemented with 3 g/day EPA+DHA (MP-FO). The exploratory endpoint was the change in the CERT2 risk score following the dietary intervention. - Results - The MP-FO group demonstrated significantly greater reductions in the CERT2 score throughout the 20-week intervention when compared to the MP group (Week 10: -2.44, 95% CI -3.42 to -1.47; Week 20: -2.18, 95% CI -3.15 to -1.21). Although the effect attenuated after 40 weeks, it remained significant (-1.63, 95% CI -2.61 to -0.65). Only the fish-oil-supplemented group displayed favourable changes in ceramide-phosphatidylcholine ratios. - Conclusions - High-dose EPA+DHA supplementation embedded in a structured heart-healthy diet reduces CERT2 in adults with increased cardiometabolic risk, indicating that this lipidomic risk score is modifiable by nutritional intervention. CERT2 may therefore serve as a responsive biomarker for monitoring improvements in cardiovascular risk beyond LDL-C in preventive cardiology. |
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| Descrizione del documento: | Gesehen am 25.08.2026 |
| Descrizione fisica: | Online Resource |
| ISSN: | 1876-4789 |
| DOI: | 10.1016/j.jacl.2026.08.013 |