Department of Dietetics and Nutritional Science, School of Health Science and Education, Harokopio University, Athens, Greece.
Department of Dietetics and Nutritional Science, School of Health Science and Education, Harokopio University, Athens, Greece.
Nutrition. 2018 Jan;45:114-124.e4. doi: 10.1016/j.nut.2017.06.023. Epub 2017 Jul 8.
Rheumatoid arthritis (RA) is a chronic, autoimmune inflammatory disease of multiple joints that puts the patient at high risk for developing cardiovascular diseases (CVDs). The aim of the present study was to conduct an up-to-date systematic review and meta-analysis of published randomized controlled trials (RCTs) to assess potential changes in RA disease activity, inflammation, and CVD risk after oral intake of ω-3 polyunsaturated fatty acids.
Publications up to July 31, 2016 were examined using the PubMed, SCOPUS, and EMBASE databases.
English language; human subjects; both sexes; RCTs; oral intake of ω-3 fatty acids; minimum duration of 3 mo; and no medication change throughout intervention. The Cochrane Risk of Bias tool was used to assess quality of trials. We included 20 RCTs, involving 717 patients with RA in the intervention group and 535 RA patients in the control group.
Despite the evidence of overall low quality of trials, consumption of ω-3 fatty acids was found to significantly improve eight disease-activity-related markers. Regarding inflammation, only leukotriene B4 was reduced (five trials, standardized mean difference [SMD], -0.440; 95% confidence interval [CI], -0.676 to -0.205; I = 46.5%; P < 0.001). A significant amelioration was found for blood triacylglycerol levels (three trials, SMD, -0.316; 95% CI, -0.561 to -0.070; I = 0.0%; P = 0.012).
The beneficial properties of ω-3 polyunsaturated fatty acids on RA disease activity confirm the results of previous meta-analyses. Among five proinflammatory markers evaluated, only leukotriene B4 was found to be reduced. However, a positive effect on blood lipid profile of patients with RA was evident, perhaps for the first time.
类风湿关节炎（RA）是一种慢性、自身免疫性炎症性多关节疾病，使患者罹患心血管疾病（CVD）的风险增高。本研究旨在对已发表的随机对照试验（RCT）进行系统回顾和荟萃分析，以评估口服ω-3 多不饱和脂肪酸后 RA 疾病活动度、炎症和 CVD 风险的潜在变化。
使用 PubMed、SCOPUS 和 EMBASE 数据库检索至 2016 年 7 月 31 日的文献。
英语文献；人体研究；男女不限；RCT；口服 ω-3 脂肪酸；至少 3 个月的疗程；干预期间无药物变化。采用 Cochrane 偏倚风险工具评估试验质量。共纳入 20 项 RCT，干预组纳入 717 例 RA 患者，对照组纳入 535 例 RA 患者。
尽管试验整体质量证据水平低，但ω-3 脂肪酸的摄入可显著改善 8 项疾病活动相关指标。关于炎症，只有白三烯 B4 降低（5 项试验，标准化均数差 [SMD]，-0.440；95%置信区间 [CI]，-0.676 至-0.205；I²=46.5%；P<0.001）。三酰甘油水平也显著改善（3 项试验，SMD，-0.316；95%CI，-0.561 至-0.070；I²=0.0%；P=0.012）。
ω-3 多不饱和脂肪酸对 RA 疾病活动的有益作用证实了以往荟萃分析的结果。在评估的 5 种促炎标志物中，只有白三烯 B4 降低。然而，ω-3 多不饱和脂肪酸对 RA 患者血脂谱的积极影响则是首次报道。
