Serum omega-3 fatty acids and treatment outcomes among women undergoing assisted reproduction
Serum omega-3 fatty acids and treatment outcomes among women undergoing assisted reproduction
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DOI：
10.1093/humrep/dex335
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发表时间：
2018-01-01
影响因子：
6.1
通讯作者：
Chavarro, J. E.
中科院分区：
文献类型：
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作者：
Chiu, Y-H;Karmon, A. E.;Chavarro, J. E.
血清多不饱和脂肪酸(PUFA)浓度，包括omega-3(omega 3-PUFA)和omega-6(omega 6-PUFA)浓度是否与ART结局有关？在接受ART的女性中，血清长链omega 3-PUFA水平与活产概率呈正相关。动物和人类研究中，摄入omega 3-PUFA可以改善卵母细胞和胚胎的质量。然而，最近的一项队列研究发现，ART后循环中的omega 3-PUFA水平与妊娠率之间没有关系。这项分析包括从马萨诸塞州综合医院生育中心的前瞻性队列研究(Earth)中随机抽取100名女性，她们在采集血液后一年内经历了136个ART周期。在刺激周期的第3天到第9天之间，用气相色谱测定血清脂肪酸(以总脂肪酸的百分比表示)。主要结果包括植入的概率、临床妊娠和每个启动周期的活产。在调整了年龄、体重指数、吸烟状况、体力活动、复合维生素的使用和活产史后，使用集群加权广义估计方程(GEE)模型分析了总PUFA和特定PUFA与ART结局的关联。血清omega3-PUFA水平中位数[第25，75百分位数]占总脂肪酸的4.7%[3.8%，5.8%]。血清长链omega 3-PUFA水平越高，临床妊娠和活产的概率越高。具体来说，经多因素调整后，血清长链omega 3-PUFA水平每升高1%，临床妊娠和活产的概率分别增加8%(4%，11%)和8%(95%CI：1%，16%)。在这些女性中，摄入长链omega 3-PUFA也与更高的生命出生概率相关，当将1%能量的长链omega 3-PUFA替换为1%能量的饱和脂肪酸时，RR为2.37(95%CI：1.02，5.51)。血清omega 6-PUFA、omega 6和omega 3-PUFA的比率以及总PUFA与ART结果无关。这些发现对未接受不孕症治疗的人群的推广可能有限。使用单一的血清脂肪酸测量来确定暴露的特征可能会导致后续的潜在错误分类。血清omega 3-PUFA被认为是饮食摄入量的生物标记物。较高的血清长链omega 3-PUFA水平与ART结果的改善之间的关联表明，增加这些脂肪的摄入量可能对接受ART不孕不育治疗的女性有利。NIH从国家环境健康科学研究所获得R01-ES009718，从国家糖尿病、消化和肾脏疾病研究所获得P30-DK046200和T32-DK007703-16，从国家儿童健康与人类发育研究所获得L50-HD085359，从美国达能营养基金会获得早期营养基金。Rueda博士参与了9,295,662项专利，即增强、改善或提高生育或生殖功能的方法()。然而，这项专利不会为Rueda博士或马萨诸塞州综合医院带来经济上的收益。Rueda博士不拥有该公司的任何股份，也不拥有任何与生育相关的公司的任何股权。由于Rueda医生不是内科医生，他不评估患者或开药。所有其他合著者都没有利益冲突要申报。
Are serum polyunsaturated fatty acids (PUFA) concentrations, including omega-3 (omega 3-PUFA) and omega-6 (omega 6-PUFA), related to ART outcomes?Serum levels of long-chain omega 3-PUFA were positively associated with probability of live birth among women undergoing ART.Intake of omega 3-PUFA improves oocyte and embryo quality in animal and human studies. However, a recent cohort study found no relation between circulating omega 3-PUFA levels and pregnancy rates after ART.This analysis included a random sample of 100 women from a prospective cohort study (EARTH) at the Massachusetts General Hospital Fertility Center who underwent 136 ART cycles within one year of blood collection.Serum fatty acids (expressed as percentage of total fatty acids) were measured by gas chromatography in samples taken between Days 3 and 9 of a stimulated cycle. Primary outcomes included the probability of implantation, clinical pregnancy and live birth per initiated cycle. Cluster-weighted generalized estimating equation (GEE) models were used to analyze the association of total and specific PUFAs with ART outcomes adjusting for age, body mass index, smoking status, physical activity, use of multivitamins and history of live birth.The median [25th, 75th percentile] serum level of omega 3-PUFA was 4.7% [3.8%, 5.8%] of total fatty acids. Higher levels of serum long-chain omega 3-PUFA were associated with higher probability of clinical pregnancy and live birth. Specifically, after multivariable adjustment, the probability of clinical pregnancy and live birth increased by 8% (4%, 11%) and 8% (95% CI: 1%, 16%), respectively, for every 1% increase in serum long-chain omega 3-PUFA levels. Intake of long-chain omega 3-PUFA was also associated with a higher probability of life birth in these women, with RR of 2.37 (95% CI: 1.02, 5.51) when replacing 1% energy of long-chain omega 3-PUFA for 1% energy of saturated fatty acids. Serum omega 6-PUFA, ratios of omega 6 and omega 3-PUFA, and total PUFA were not associated with ART outcomes.The generalizability of the findings to populations not undergoing infertility treatment may be limited. The use of a single measurement of serum fatty acids to characterize exposure may lead to potential misclassification during follow up.Serum omega 3-PUFA are considered biomarkers of dietary intake. The association of higher serum long chain omega 3-PUFA levels with improved ART outcomes suggests that increased intake of these fats be may be beneficial for women undergoing infertility treatment with ART.NIH grants R01-ES009718 from the National Institute of Environmental Health Sciences, P30-DK046200 and T32-DK007703-16 from the National Institute of Diabetes and Digestive and Kidney Diseases, and L50-HD085359 from the National Institute of Child Health and Human Development, and the Early Life Nutrition Fund from Danone Nutricia US. Dr Rueda is involved in a patent 9,295,662, methods for enhancing, improving, or increasing fertility or reproductive function (). This patent, however, does not lead to financial gain for Dr Rueda, or for Massachusetts General Hospital. Dr Rueda does not own any part of the company nor does he have any equity in any fertility related company. As Dr Rueda is not a physician, he does not evaluate patients or prescribe medications. All other coauthors have no conflicts of interest to declare.