Abbott Kylie A, Burrows Tracy L, Thota Rohith N, Acharya Shamasunder, Garg Manohar L
Schools of Biomedical Sciences and Pharmacy and.
Health Sciences, University of Newcastle, Callaghan, Australia; and.
Am J Clin Nutr. 2016 Nov;104(5):1470-1484. doi: 10.3945/ajcn.116.138172. Epub 2016 Sep 28.
Evidence has suggested that omega-3 (n-3) polyunsaturated fatty acids (PUFAs) improve obesity-induced insulin resistance (IR); however, results from human intervention trials have been equivocal. Recently it has been reported that n-3 PUFA status is inversely associated with type 2 diabetes in women but not in men, suggesting a sex-dependent effect.
We aimed to determine whether n-3 PUFA interventions affect IR in a sex-dependent manner.
Five databases were searched (Medline, EMBASE, CINAHL, Scopus, and Pre-Medline) for randomized controlled trials. Searches were limited to the English language and to studies with adults aged >18 y. When possible, studies were pooled for a meta-analysis. The principle summary measure was the standardized mean difference (SMD) between groups.
Thirty-one eligible trials were identified with a total of 1848 participants [men: 45.1%; weighted mean ± SD age: 52.5 ± 8.2 y; weighted body mass index (in kg/m): 28.8 ± 3.0]. Seven studies were conducted in women, 4 studies were conducted in men, and the remaining studies pooled men and women together. Twenty-six trials were pooled for the meta-analysis (men: n = 2; women: n = 6). With all studies (n = 26) pooled, there was no effect of n-3 PUFA on IR at the group level (SMD: 0.089; 95% CI: -0.105, 0.283; P = 0.367). In trials of ≥6 wk, a significant improvement in IR was seen in women (SMD: -0.266; 95% CI: -0.524, -0.007; P = 0.045) but not in men (SMD: 0.619; 95% CI: -0.583, 1.820; P = 0.313).
With this analysis, we provide preliminary evidence of a sex-dependent response of IR to an n-3 PUFA intervention. Additional studies are needed to confirm sex-dependent associations and to elucidate the potential mechanisms that are involved. This trial was registered at www.crd.york.ac.uk/PROSPERO/ as CRD42015017940.
有证据表明，ω-3（n-3）多不饱和脂肪酸（PUFA）可改善肥胖诱导的胰岛素抵抗（IR）；然而，人体干预试验的结果并不明确。最近有报道称，n-3多不饱和脂肪酸状态与女性2型糖尿病呈负相关，而与男性无关，提示存在性别依赖性效应。
我们旨在确定n-3多不饱和脂肪酸干预是否以性别依赖性方式影响胰岛素抵抗。
检索了五个数据库（Medline、EMBASE、CINAHL、Scopus和Pre-Medline）以查找随机对照试验。检索限于英文文献以及针对18岁以上成年人的研究。如有可能，将研究合并进行荟萃分析。主要汇总指标是组间标准化均数差（SMD）。
共确定了31项符合条件的试验，共有1848名参与者[男性：45.1%；加权平均±标准差年龄：52.5±8.2岁；加权体重指数（kg/m²）：28.8±3.0]。7项研究在女性中进行，4项研究在男性中进行，其余研究将男性和女性合并在一起。26项试验被纳入荟萃分析（男性：n = 2；女性：n = 6）。将所有研究（n = 26）合并后，n-3多不饱和脂肪酸在组水平上对胰岛素抵抗没有影响（SMD：0.089；95%CI：-0.105，0.283；P = 0.367）。在≥6周的试验中，女性的胰岛素抵抗有显著改善（SMD：-0.266；95%CI：-0.524，-0.007；P = 0.045），而男性没有（SMD：0.619；95%CI：-0.583，1.820；P = 0.313）。
通过这项分析，我们提供了胰岛素抵抗对n-3多不饱和脂肪酸干预存在性别依赖性反应的初步证据。需要更多研究来证实性别依赖性关联，并阐明其中涉及的潜在机制。该试验已在www.crd.york.ac.uk/PROSPERO/注册，注册号为CRD42015017940。
