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补充ω-3脂肪酸对2型糖尿病患者血糖控制和血脂水平的影响:一项荟萃分析。

Effects of Omega-3 Fatty Acid Supplementation on Glucose Control and Lipid Levels in Type 2 Diabetes: A Meta-Analysis.

作者信息

Chen Cai, Yu Xuefeng, Shao Shiying

机构信息

Division of Endocrinology, Tongji Hospital, Huazhong University of Science & Technology, Wuhan, PR China, 430030; The center for Biomedical Research, Tongji Hospital, Huazhong University of Science & Technology, Wuhan, PR China, 430030.

Division of Endocrinology, Tongji Hospital, Huazhong University of Science & Technology, Wuhan, PR China, 430030.

出版信息

PLoS One. 2015 Oct 2;10(10):e0139565. doi: 10.1371/journal.pone.0139565. eCollection 2015.

Abstract

BACKGROUND

Many studies assessed the impact of marine omega-3 fatty acids on glycemic homeostasis and lipid profiles in patients with type 2 diabetes (T2DM), but reported controversial results. Our goal was to systematically evaluate the effects of omega-3 on glucose control and lipid levels.

METHODS

Medline, Pubmed, Cochrane Library, Embase, the National Research Register, and SIGLE were searched to identify eligible randomized clinical trials (RCTs). Extracted data from RCTs were analyzed using STATA 11.0 statistical software with fixed or random effects model. Effect sizes were presented as weighted mean differences (WMD) with 95% confidence intervals (95% CI). Heterogeneity was assessed using the Chi-square test with significance level set at p < 0.1.

RESULTS

20 RCT trials were included into this meta-analysis. Among patients with omega-3 supplementation, triglyceride (TG) levels were significantly decreased by 0.24 mmol/L. No marked change in total cholesterol (TC), HbA1c, fasting plasma glucose, postprandial plasma glucose, BMI or body weight was observed. High ratio of EPA/DHA contributed to a greater decreasing tendency in plasma insulin, HbAc1, TC, TG, and BMI measures, although no statistical significance was identified (except TG). FPG levels were increased by 0.42 mmol/L in Asians. No evidence of publication bias was observed in this meta-analysis.

CONCLUSIONS

The ratio of EPA/DHA and early intervention with omega 3 fatty acids may affect their effects on glucose control and lipid levels, which may serve as a dietary reference for clinicians or nutritionists who manage diabetic patients.

摘要

背景

许多研究评估了海洋ω-3脂肪酸对2型糖尿病(T2DM)患者血糖稳态和血脂谱的影响,但报告的结果存在争议。我们的目标是系统评价ω-3对血糖控制和血脂水平的影响。

方法

检索Medline、Pubmed、Cochrane图书馆、Embase、国家研究注册库和SIGLE,以确定符合条件的随机临床试验(RCT)。使用STATA 11.0统计软件,采用固定或随机效应模型对RCT中提取的数据进行分析。效应量以加权平均差(WMD)及其95%置信区间(95%CI)表示。采用卡方检验评估异质性,显著性水平设定为p<0.1。

结果

本荟萃分析纳入了20项RCT试验。在补充ω-3的患者中,甘油三酯(TG)水平显著降低0.24 mmol/L。未观察到总胆固醇(TC)、糖化血红蛋白(HbA1c)、空腹血糖、餐后血糖、体重指数(BMI)或体重有明显变化。尽管未发现统计学意义(TG除外),但较高的二十碳五烯酸(EPA)/二十二碳六烯酸(DHA)比例导致血浆胰岛素、糖化血红蛋白(HbAc1)、TC、TG和BMI指标有更大的下降趋势。亚洲人的空腹血糖(FPG)水平升高了0.42 mmol/L。本荟萃分析未观察到发表偏倚的证据。

结论

EPA/DHA比例以及ω-3脂肪酸的早期干预可能会影响其对血糖控制和血脂水平的作用,这可为管理糖尿病患者的临床医生或营养师提供饮食参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16e4/4591987/7f54cc914e31/pone.0139565.g001.jpg

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