James Stephen, Montgomery Paul, Williams Katrina
School of Social Work, Arizona State University, Phoenix, Arizona, USA.
Cochrane Database Syst Rev. 2011 Nov 9(11):CD007992. doi: 10.1002/14651858.CD007992.pub2.
It has been suggested that impairments associated with autism spectrum disorders (ASD) may be partially explained by deficits of omega-3 fatty acids, and that supplementation of these essential fatty acids may lead to improvement of symptoms.
To review the efficacy of omega-3 fatty acids for improving core features of ASD (for example, social interaction, communication, and stereotypies) and associated symptoms.
We searched the following databases on 2 June 2010: CENTRAL (2010, Issue 2), MEDLINE (1950 to May Week 3 2010), EMBASE (1980 to 2010 Week 21), PsycINFO (1806 to current), BIOSIS (1985 to current), CINAHL (1982 to current), Science Citation Index (1970 to current), Social Science Citation Index (1970 to current), metaRegister of Controlled Trials (20 November 2008) and ClinicalTrials.gov (10 December 2010). Dissertation Abstracts International was searched on 10 December 2008, but was no longer available to the authors or editorial base in 2010.
All randomised controlled trials of omega-3 fatty acids supplementation compared to placebo in individuals with ASD.
Three authors independently selected studies, assessed them for risk of bias and extracted relevant data. We conducted meta-analysis of the included studies for three primary outcomes (social interaction, communication, and stereotypy) and one secondary outcome (hyperactivity).
We included two trials with a total of 37 children diagnosed with ASD who were randomised into groups that received either omega-3 fatty acids supplementation or a placebo. We excluded six trials because they were either non-randomised controlled trials, did not contain a control group, or the control group did not receive a placebo. Overall, there was no evidence that omega-3 supplements had an effect on social interaction (mean difference (MD) 0.82, 95% confidence interval (CI) -2.84 to 4.48, I(2) = 0%), communication (MD 0.62, 95% CI -0.89 to 2.14, I(2) = 0%), stereotypy (MD 0.77, 95% CI -0.69 to 2.22, I(2) = 8%), or hyperactivity (MD 3.46, 95% CI -0.79 to 7.70, I(2) = 0%).
AUTHORS' CONCLUSIONS: To date there is no high quality evidence that omega-3 fatty acids supplementation is effective for improving core and associated symptoms of ASD. Given the paucity of rigorous studies in this area, there is a need for large well-conducted randomised controlled trials that examine both high and low functioning individuals with ASD, and that have longer follow-up periods.
有观点认为，与自闭症谱系障碍（ASD）相关的功能损害可能部分归因于ω-3脂肪酸缺乏，补充这些必需脂肪酸可能会改善症状。
综述ω-3脂肪酸改善ASD核心特征（如社交互动、沟通和刻板行为）及相关症状的疗效。
我们于2010年6月2日检索了以下数据库：考克兰系统评价数据库（2010年第2期）、医学索引数据库（1950年至2010年第3周）、荷兰医学文摘数据库（1980年至2010年第21周）、心理学文摘数据库（1806年至今）、生物学文摘数据库（1985年至今）、护理学与健康照护数据库（1982年至今）、科学引文索引数据库（1970年至今）、社会科学引文索引数据库（1970年至今）、对照试验元注册库（2008年11月20日）和临床试验数据库（2010年12月10日）。2008年12月10日检索了国际学位论文摘要数据库，但作者或编辑团队在2010年无法再获取该数据库。
所有将补充ω-3脂肪酸与安慰剂进行对比的针对ASD个体的随机对照试验。
三位作者独立选择研究，评估其偏倚风险并提取相关数据。我们对纳入研究的三项主要结局（社交互动、沟通和刻板行为）及一项次要结局（多动）进行了荟萃分析。
我们纳入了两项试验，共37名被诊断为ASD的儿童被随机分为接受ω-3脂肪酸补充剂或安慰剂的组。我们排除了六项试验，因为它们要么是非随机对照试验，没有对照组，要么对照组未接受安慰剂。总体而言，没有证据表明ω-3补充剂对社交互动（平均差（MD）0.82，95%置信区间（CI）-2.84至4.48，I² = 0%）、沟通（MD 0.62，95% CI -0.89至2.14，I² = 0%）、刻板行为（MD 0.77，95% CI -0.69至2.22，I² = 8%）或多动（MD 3.46，95% CI -0.79至7.70，I² = 0%）有影响。
迄今为止，尚无高质量证据表明补充ω-3脂肪酸对改善ASD的核心及相关症状有效。鉴于该领域严格研究较少，需要开展大规模、精心设计的随机对照试验，纳入功能高低不同的ASD个体，并进行更长时间的随访。
