Hartweg Janine, Farmer Andrew J, Holman Rury R, Neil Andrew
Division of Public Health and Primary Healthcare, University of Oxford, Oxford, UK.
Curr Opin Lipidol. 2009 Feb;20(1):30-8. doi: 10.1097/mol.0b013e328321b3be.
Hypothesis-generating systematic review of the impact of marine-derived omega-3 polyunsaturated fatty acids (PUFAs) on lipid, glycemic and hematological risk factors in type 2 diabetes using pooled data from randomized controlled trials searched up to 20 September 2008.
Seven new trials in 2007 and 2008 were identified from 206 abstracts to give a total of 24 trials between 1966 and 2008 involving 1533 participants that could be pooled. The mean omega-3 PUFAs dose and duration of treatment in the new trials was 2.4 g/day and 24 weeks, respectively. Compared with placebo, omega-3 PUFAs supplementation decreased triglycerides by 7% (mean -0.17 mmol/l, 24 trials, 1530 participants), fibrinogen by 10% (mean -0.96 micromol/l, three trials, 159 participants), ADP platelet aggregation to ADP by 22% (mean -10.30%, two trials, 64 participants) and to collagen by 21% (mean -10.55%, two trials, 64 participants), with an LDL-cholesterol increase of 3% (mean 0.08 mmol/l, 21 trials, 1104 participants). None of the following risk factors appeared to be beneficially influenced: HDL-cholesterol, LDL particle size, glycemia, insulinemia, inflammatory biomarkers, blood pressure. However for some of these risk factors (such as inflammatory biomarkers) the number of trial patients was small Higher doses of omega-3 PUFAs (>or=2 g/day) may have greater triglyceride lowering effects.
This systematic review and meta-analysis confirms the triglyceride lowering effects of omega-3 PUFAs, demonstrates potential dose-response effects and shows improvements in thrombogenesis. Omega-3 PUFAs raise LDL levels without concomitant changes in lipid particle size. Changes seen in conventional risk factors are insufficient to explain the cardiovascular disease risk reductions suggested to occur with omega-3 PUFAs.
通过汇总截至2008年9月20日检索到的随机对照试验数据，对海洋来源的ω-3多不饱和脂肪酸（PUFAs）对2型糖尿病患者脂质、血糖和血液学风险因素的影响进行假设生成系统评价。
从206篇摘要中识别出2007年和2008年的7项新试验，使得1966年至2008年间共有24项试验，涉及1533名可汇总的参与者。新试验中ω-3 PUFAs的平均剂量和治疗持续时间分别为2.4克/天和24周。与安慰剂相比，补充ω-3 PUFAs可使甘油三酯降低7%（平均-0.17毫摩尔/升，24项试验，1530名参与者），纤维蛋白原降低10%（平均-0.96微摩尔/升，3项试验，159名参与者），ADP诱导的血小板聚集降低22%（平均-10.30%，2项试验，64名参与者），胶原诱导的血小板聚集降低21%（平均-10.55%，2项试验，64名参与者），低密度脂蛋白胆固醇升高3%（平均0.08毫摩尔/升，21项试验，1104名参与者）。以下风险因素似乎均未受到有益影响：高密度脂蛋白胆固醇、低密度脂蛋白颗粒大小、血糖、胰岛素血症、炎症生物标志物、血压。然而，对于其中一些风险因素（如炎症生物标志物），试验患者数量较少。更高剂量的ω-3 PUFAs（≥2克/天）可能具有更大的降低甘油三酯的作用。
该系统评价和荟萃分析证实了ω-3 PUFAs降低甘油三酯的作用，显示出潜在的剂量反应效应，并表明其对血栓形成有改善作用。ω-3 PUFAs会升高低密度脂蛋白水平，而脂质颗粒大小无相应变化。传统风险因素的变化不足以解释ω-3 PUFAs所提示的心血管疾病风险降低情况。
