Eicosapentaenoic acid reduces the progression of carotid intima-media thickness in patients with type 2 diabetes

To investigate the effect of highly purified eicosapentaenoic acid (EPA) on the progression of diabetic macroangiopathy, we performed an open-label randomized prospective trial. A total of 81 Japanese type 2 diabetes were randomly assigned to the EPA (1800 mg/day) treated group or the control group. Carotid intima-media thickness (IMT) and brachial-ankle pulse wave velocity (baPWV) were evaluated before and after treatment in both groups. Sixty patients (EPA group, n = 30; control group, n = 30) completed this study. During the study period of 2.1 ± 0.2 years, the mean IMT and max IMT of the EPA treated group showed a significant annual decrease compared with that of the control group (mean IMT, −0.029 ± 0.112 mm versus 0.016 ± 0.109 mm, respectively, P = 0.029; max IMT, −0.084 ± 0.113 mm versus −0.005 ± 0.108 mm, respectively, P = 0.0008). The baPWV was also improved significantly in the EPA treated group compared with the control group (−22.1 ± 127.9 cm/s versus 62.3 ± 223 cm/s, respectively, P = 0.021). Multiple regression analysis showed that the administration of EPA was a significant and independent factor associated with an annual improvement of mean IMT (R2 = 0.067). In summary, this is the first demonstration that administration of purified EPA improves the carotid IMT and the baPWV in patients with type 2 diabetes.