Department of Basic Medical Sciences, Neyshabur University of Medical Sciences, Neyshabur, Iran.
Department of Clinical Biochemistry, Shahid Sadoughi University of Medical Sciences, Yazd, Zip code: 9314634814, Iran.
Acta Diabetol. 2018 Jul;55(7):641-652. doi: 10.1007/s00592-018-1110-6. Epub 2018 Feb 16.
N-3 PUFAs can potentially influence levels of inflammatory and non-inflammatory adipokines. Given the contradictory effects of n-3 PUFAs on serum levels of adipokines in type 2 diabetes, we conducted a systematic review and meta-analysis study of randomized placebo-controlled clinical trials that examined the effects of n-3 PUFAs on serum levels of leptin and adiponectin in patients with type 2 diabetes.
The electronic databases, without regard to language restrictions including PubMed/Medline, Google Scholar, SCOPUS and ISI Web of Science until August 2017, were used to identify randomized controlled trials that assessed the effect of n-3 PUFAs on serum leptin and adiponectin concentrations in type 2 diabetes. Outcomes were extracted based on the mean ± SD as effect size at baseline and end of the intervention. Between-study heterogeneity was evaluated by the I estimates and their 95% CIs. Funnel plot asymmetry was used to investigate the existence of publication bias. Stata software and Review Manager were used for statistical data analysis.
Data from 10 eligible articles involved 494 subjects with type 2 diabetes mellitus (intervention groups = 254 and control groups = 240), with age between 44 and 70 years, treated with doses of 0.52-7.4 g/day n-3 PUFAs. Adiponectin concentration nonsignificantly increased by a MD = 0.17 µg/mL (95% CI - 0.11, 0.44). Also, leptin concentration nonsignificantly reduced by a MD = - 0.31 ng/mL (95% CI - 0.69, 0.07).
Plant and marine sources of n-3 PUFAs can modify serum leptin and adiponectin levels by increasing adiponectin and decreasing leptin levels in patients with type 2 diabetes. Due to some limitations in this study, further studies are needed to reach a definitive conclusion about the effect of n-3 PUFAs on the levels of leptin and adiponectin in T2DM.
N-3 多不饱和脂肪酸（PUFAs）可能影响炎症性和非炎症性脂肪因子的水平。鉴于 n-3 PUFAs 对 2 型糖尿病患者血清脂肪因子水平的影响存在矛盾，我们进行了一项系统评价和荟萃分析研究，纳入了评估 n-3 PUFAs 对 2 型糖尿病患者血清瘦素和脂联素水平影响的随机安慰剂对照临床试验。
检索电子数据库（包括 PubMed/Medline、Google Scholar、SCOPUS 和 ISI Web of Science），不考虑语言限制，检索时间截至 2017 年 8 月，以确定评估 n-3 PUFAs 对 2 型糖尿病患者血清瘦素和脂联素浓度影响的随机对照试验。根据基线和干预结束时的均数±标准差，提取效应量作为结局指标。采用 I ² 估计值及其 95%可信区间评估研究间异质性。采用漏斗图分析评估发表偏倚的存在。Stata 软件和 Review Manager 用于统计数据分析。
纳入 10 项符合条件的研究，共涉及 494 例 2 型糖尿病患者（干预组 254 例，对照组 240 例），年龄 44-70 岁，n-3 PUFAs 剂量为 0.52-7.4 g/天。脂联素浓度平均增加 MD=0.17 µg/mL（95%CI -0.11，0.44），差异无统计学意义。瘦素浓度平均降低 MD=-0.31 ng/mL（95%CI -0.69，0.07），差异无统计学意义。
植物和海洋来源的 n-3 PUFAs 可通过增加 2 型糖尿病患者的脂联素水平和降低瘦素水平来调节血清瘦素和脂联素水平。由于本研究存在一些局限性，需要进一步研究以确定 n-3 PUFAs 对 2 型糖尿病患者瘦素和脂联素水平的影响。
