van Gool C J A W, Zeegers M P A, Thijs C
Department of Epidemiology, Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Maastricht University, Maastricht, The Netherlands.
Br J Dermatol. 2004 Apr;150(4):728-40. doi: 10.1111/j.0007-0963.2004.05851.x.
Essential fatty acids are components of cell membranes and precursors of immunomodulating factors that may play a role in the inflammatory and immunological pathogenesis of atopic dermatitis. Trials of supplementation with essential fatty acids (EFA) to alleviate atopic dermatitis (AD) have given inconsistent results.
To summarize and quantify the results of placebo-controlled trials with EFA for AD.
Publications of clinical trials were searched in a systematic way and the study characteristics assessed independently by three assessors. Trials were selected for inclusion in the meta-analysis when they had included a placebo group and when the outcome measure included the severity of AD. The pooled effect sizes of improvement of the overall severity of AD were calculated by random effects meta-analysis. The dependence of the results on study characteristics was studied using meta-regression analysis.
We identified 34 publications of controlled trials in AD up to April 2002. Nineteen trials of gamma-linolenic acid (GLA) and five trials of fish oil matched our inclusion criterion of placebo-controlled trial. The effect size of GLA supplementation on the improvement of the overall severity of AD could be calculated from 11 of these trials. The pooled effect size was 0.15 [95% confidence limits (CL) - 0.02, 0.32]. The effect size of fish oil supplementation, calculated from three trials was - 0.01 (95% CL - 0.37, 0.30). For component subscales such as itch, scaling and lichenification, EFA supplementation showed no benefit. The study characteristics showed no detectable influence on the overall result.
Supplementation with EFA has no clinically relevant effect on the severity of AD.
必需脂肪酸是细胞膜的组成成分以及免疫调节因子的前体，可能在特应性皮炎的炎症和免疫发病机制中发挥作用。补充必需脂肪酸（EFA）以缓解特应性皮炎（AD）的试验结果并不一致。
总结并量化使用EFA治疗AD的安慰剂对照试验结果。
系统检索临床试验出版物，由三名评估者独立评估研究特征。当试验包含安慰剂组且结果测量包括AD严重程度时，将其纳入荟萃分析。通过随机效应荟萃分析计算AD总体严重程度改善的合并效应量。使用荟萃回归分析研究结果对研究特征的依赖性。
截至2002年4月，我们确定了34篇关于AD对照试验的出版物。19项γ-亚麻酸（GLA）试验和5项鱼油试验符合我们安慰剂对照试验的纳入标准。其中11项试验可计算出补充GLA对AD总体严重程度改善的效应量。合并效应量为0.15 [95%置信区间（CL）-0.02，0.32]。三项试验计算出的补充鱼油的效应量为-0.01（95%CL -0.37，0.30）。对于瘙痒、脱屑和苔藓化等亚量表，补充EFA未显示出益处。研究特征对总体结果未显示出可检测到的影响。
补充EFA对AD的严重程度没有临床相关影响。
