Department of Adipose Tissue Biology, Institute of Physiology Academy of Sciences of the Czech Republic, Prague, Czech Republic.
Physiol Res. 2014;63(Suppl 1):S93-118. doi: 10.33549/physiolres.932715.
Type 2 diabetes (T2D) as well as cardiovascular disease (CVD) represent major complications of obesity and associated metabolic disorders (metabolic syndrome). This review focuses on the effects of long-chain n-3 polyunsaturated fatty acids (omega-3) on insulin sensitivity and glucose homeostasis, which are improved by omega-3 in many animal models of metabolic syndrome, but remain frequently unaffected in humans. Here we focus on: (i) mechanistic aspects of omega-3 action, reflecting also our experiments in dietary obese mice; and (ii) recent studies analysing omega-3's effects in various categories of human subjects. Most animal experiments document beneficial effects of omega-3 on insulin sensitivity and glucose metabolism even under conditions of established obesity and insulin resistance. Besides positive results obtained in both cross-sectional and prospective cohort studies on healthy human populations, also some intervention studies in prediabetic subjects document amelioration of impaired glucose homeostasis by omega-3. However, the use of omega-3 to reduce a risk of new-onset diabetes in prediabetic subjects still remains to be further characterized. The results of a majority of clinical trials performed in T2D patients suggest that omega-3 have none or marginal effects on metabolic control, while effectively reducing hypertriglyceridemia in these patients. Despite most of the recent randomized clinical trials do not support the role of omega-3 in secondary prevention of CVD, this issue remains still controversial. Combined interventions using omega-3 and antidiabetic or hypolipidemic drugs should be further explored and considered for treatment of patients with T2D and other diseases.
2 型糖尿病（T2D）和心血管疾病（CVD）是肥胖和相关代谢紊乱（代谢综合征）的主要并发症。本综述重点关注长链 n-3 多不饱和脂肪酸（ω-3）对胰岛素敏感性和葡萄糖稳态的影响，在许多代谢综合征的动物模型中，ω-3 可改善胰岛素敏感性和葡萄糖稳态，但在人类中通常不受影响。在这里，我们重点关注：（i）ω-3 作用的机制方面，这也反映了我们在饮食诱导肥胖小鼠中的实验；（ii）最近分析 ω-3 在各种人类受试者类别中作用的研究。大多数动物实验证明，即使在肥胖和胰岛素抵抗已经确立的情况下，ω-3 对胰岛素敏感性和葡萄糖代谢仍有有益影响。除了在健康人群的横断面和前瞻性队列研究中获得的阳性结果外，一些在糖尿病前期受试者中进行的干预研究也记录了 ω-3 改善葡萄糖稳态受损的情况。然而，使用 ω-3 降低糖尿病前期受试者新发糖尿病的风险仍有待进一步研究。在 T2D 患者中进行的大多数临床试验的结果表明，ω-3 对代谢控制没有影响或影响很小，而有效降低了这些患者的高甘油三酯血症。尽管最近的大多数随机临床试验不支持 ω-3 在 CVD 二级预防中的作用，但这个问题仍然存在争议。应该进一步探索和考虑使用 ω-3 与抗糖尿病或降血脂药物联合干预治疗 T2D 及其他疾病的患者。
