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EPA-rich fish oil refers to a dietary supplement formulation primarily composed of eicosapentaenoic acid (EPA), an omega-3 polyunsaturated fatty acid. In the context of research conducted by the National Heart, Lung, and Blood Institute (NHLBI), specifically protocol 15-H-0173 (NCT02434003), this formulation was evaluated in a randomized, double-blind, crossover pilot trial to compare its effects against DHA-rich fish oil on lipoprotein metabolism and plasma PCSK9 levels in adults with hypertriglyceridemia. EPA is known to lower triglyceride levels by inhibiting hepatic lipogenesis, specifically by reducing the activity of enzymes like diacylglycerol O-acyltransferase (DGAT) and acting as an agonist for peroxisome proliferator-activated receptor alpha (PPAR-alpha), which increases fatty acid oxidation. The NHLBI study specifically aimed to understand how EPA-rich versus DHA-rich oils differentially affect the clearance and production of various lipoprotein particles and the regulation of LDL receptors via PCSK9.
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