Omega-3 polyunsaturated fatty acids favourably modulate cardiometabolic biomarkers in type 2 diabetes: a meta-analysis and meta-regression of randomized controlled trials.
Omega-3 polyunsaturated fatty acids favourably modulate cardiometabolic biomarkers in type 2 diabetes: a meta-analysis and meta-regression of randomized controlled trials.
复制标题
DOI：
10.1186/s12933-018-0740-x
复制
发表时间：
2018-07-07
影响因子：
9.3
通讯作者：
Campbell MD
中科院分区：
文献类型：
--
作者：
O'Mahoney LL;Matu J;Price OJ;Birch KM;Ajjan RA;Farrar D;Tapp R;West DJ;Deighton K;Campbell MD
随机对照试验(RCT)表明，补充omega-3多不饱和脂肪酸(n-3PUFAs)可能有利于修改2型糖尿病(T2 DM)的心脏代谢生物标志物。以前的荟萃分析受到样本数量不足和元回归技术遗漏的限制，自上次全面的荟萃分析以来，随后发表了大量随机对照试验。因此，关于剂量、持续时间或这两个因素之间相互作用的影响的最新信息是必要的。目的是全面评估补充n-3PUFAs对T2 DM患者心脏代谢生物标志物的影响，包括血脂、炎症参数、血压和血糖控制指数，并确定治疗剂量、持续时间或其相互作用是否会改变这些影响。在包括PubMed和MEDLINE的数据库中搜索RCT，直到2017年7月13日，调查补充n-3PUFAs对血脂、炎症参数、血压和血糖控制指数的影响。使用随机效应荟萃分析将数据合并，并以标准化平均差(Hedge G)表示，可信区间为95%(95%CI)。在适当的情况下，采用Meta回归分析来考察补充时间和n-3PUFAs总剂量作为调节变量的影响。总共确定了45个随机对照试验，涉及2674名T2 DM患者。补充N-3PUFAs与显著降低低密度脂蛋白[ES：− 0.10，(95%CI− 0.17，− 0.03)；p = 0.007]，极低密度脂蛋白(ES：− 0.26(− 0.51，− 0.01)；p = 0.044]，甘油三酯(ES：− 0.39(− 0.55，− 0.24；和HbA1c(Es：− 0.27(− 0.48，− 0.06)；p = 0.010)。此外，补充n-3PUFAs还可降低血浆肿瘤坏死因子-α[Es：− 0.59(− 1.17，− 0.01)；p = 0.045]和IL-6[Es：− 1.67(− 3.14，− 0.20)；p = 0.026]。所有其他血脂标记物、血糖控制指数、炎症参数和血压均保持不变(p >； 0.05)。补充N-3PUFAs可产生良好的降血脂效果，降低促炎细胞因子水平并改善血糖。持续时间和剂量似乎都不能解释观察到的对n-3PUFAs反应的异质性。试验注册本试验在http://www.crd.york.ac.uk注册为CRD42016050802本文的在线版本(10.1186/s12933-0180740-x)包含补充材料，授权用户可以使用。
Randomized controlled trials (RCTs) suggest that supplementation with omega-3 polyunsaturated fatty acids (n-3PUFAs) may favourably modify cardiometabolic biomarkers in type 2 diabetes (T2DM). Previous meta-analyses are limited by insufficient sample sizes and omission of meta-regression techniques, and a large number of RCTs have subsequently been published since the last comprehensive meta-analysis. Updated information regarding the impact of dosage, duration or an interaction between these two factors is therefore warranted. The objective was to comprehensively assess the effect of n-3PUFAs supplementation on cardiometabolic biomarkers including lipid profiles, inflammatory parameters, blood pressure, and indices of glycaemic control, in people with T2DM, and identify whether treatment dosage, duration or an interaction thereof modify these effects. Databases including PubMed and MEDLINE were searched until 13th July 2017 for RCTs investigating the effect of n-3PUFAs supplementation on lipid profiles, inflammatory parameters, blood pressure, and indices of glycaemic control. Data were pooled using random-effects meta-analysis and presented as standardised mean difference (Hedges g) with 95% confidence intervals (95% CI). Meta-regression analysis was performed to investigate the effects of duration of supplementation and total dosage of n-3PUFAs as moderator variables where appropriate. A total of 45 RCTs were identified, involving 2674 people with T2DM. n-3PUFAs supplementation was associated with significant reductions in LDL [ES: − 0.10, (95% CI − 0.17, − 0.03); p = 0.007], VLDL (ES: − 0.26 (− 0.51, − 0.01); p = 0.044], triglycerides (ES: − 0.39 (− 0.55, − 0.24; p ≤ 0.001] and HbA1c (ES: − 0.27 (− 0.48, − 0.06); p = 0.010]. Moreover, n-3PUFAs supplementation was associated with reduction in plasma levels of TNF-α [ES: − 0.59 (− 1.17, − 0.01); p = 0.045] and IL-6 (ES: − 1.67 (− 3.14, − 0.20); p = 0.026]. All other lipid markers, indices of glycaemic control, inflammatory parameters, and blood pressure remained unchanged (p > 0.05). n-3PUFAs supplementation produces favourable hypolipidemic effects, a reduction in pro-inflammatory cytokine levels and improvement in glycaemia. Neither duration nor dosage appear to explain the observed heterogeneity in response to n-3PUFAs. Trial registration This trial was registered at http://www.crd.york.ac.uk as CRD42016050802 The online version of this article (10.1186/s12933-018-0740-x) contains supplementary material, which is available to authorized users.
登录
查看更多内容
影响因子：
5.6
作者：
Innes JK;Calder PC
通讯作者：
Calder PC
影响因子：
5.9
作者：
Jacobo-Cejudo MG;Valdés-Ramos R;Guadarrama-López AL;Pardo-Morales RV;Martínez-Carrillo BE;Harbige LS
通讯作者：
Harbige LS
影响因子：
39.2
作者：
GLAUBER, H;WALLACE, P;BRECHTEL, G
通讯作者：
BRECHTEL, G
DOI：
10.1002/lite.201300290
发表时间：
2013-01-01
期刊：
Lipid Technology
影响因子：
--
作者：
Harris, W. S.
通讯作者：
Harris, W. S.
影响因子：
158.5
作者：
Holman, Rury R.;Paul, Sanjoy K.;Neil, H. Andrew W.
通讯作者：
Neil, H. Andrew W.