Institute of Nutrition and Health, Qingdao University, Qingdao, China.
Department of Food Science and Nutrition, Zhejiang University, Hangzhou, China.
Crit Rev Food Sci Nutr. 2019;59(20):3380-3393. doi: 10.1080/10408398.2018.1492901. Epub 2019 Feb 4.
The present study aimed to clarify whether eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have differential effects on blood pressure and inflammatory mediators. A systematic literature search was conducted in PubMed and Scopus updated to Apr. 2018. The mean changes in risk factors of chronic diseases were calculated as weighted mean difference (WMD) by using a random-effects model. Twenty randomized controlled trials (RCTs) were included. The summary estimate showed that EPA intervention significantly reduced systolic blood pressure (SBP) (-2.6 mmHg; 95%confident interval (CI): -4.6, -0.5 mmHg), especially in subjects with dyslipidemia (-3.8 mmHg; 95%CI: -6.7, -0.8 mmHg). The pooled effect indicated that supplemental DHA exerted a significant reduction in diastolic blood pressure (DBP) in subjects with dyslipidemia (-3.1 mmHg; 95%CI: -5.9, -0.2 mmHg). Both EPA (-0.56 mg/L; 95%CI: -1.13, 0.00) and DHA (-0.5 mg/L; 95%CI: -1.0, -0.03) significantly reduced the concentrations of C-reactive protein (CRP), respectively, especially in subjects with dyslipidemia and higher baseline CRP concentrations. Given that limited trials have focused on EPA or DHA intervention on concentrations of interleukin (IL)-6 and tumor necrosis factor (TNF)-α, further RCTs should be explored on these inflammatory factors. The present meta-analysis provides substantial evidence that EPA and DHA have independent (blood pressure) and shared (CRP concentration) effects on risk factors of chronic diseases, and high-quality RCTs with multi-center and large simple-size should be performed to confirm the present findings.
本研究旨在阐明二十碳五烯酸 (EPA) 和二十二碳六烯酸 (DHA) 是否对血压和炎症介质有不同的影响。在 PubMed 和 Scopus 中进行了系统的文献检索，检索截至 2018 年 4 月。使用随机效应模型计算慢性病危险因素的平均变化作为加权均数差 (WMD)。共纳入 20 项随机对照试验 (RCT)。汇总估计表明，EPA 干预可显著降低收缩压 (SBP) (-2.6mmHg；95%置信区间 [CI]：-4.6，-0.5mmHg)，尤其是在血脂异常患者中 (-3.8mmHg；95%CI：-6.7，-0.8mmHg)。汇总效应表明，补充 DHA 可显著降低血脂异常患者的舒张压 (DBP) (-3.1mmHg；95%CI：-5.9，-0.2mmHg)。EPA (-0.56mg/L；95%CI：-1.13，0.00) 和 DHA (-0.5mg/L；95%CI：-1.0，-0.03) 均可显著降低 C 反应蛋白 (CRP) 的浓度，尤其是在血脂异常和基线 CRP 浓度较高的患者中。鉴于目前仅有少数试验关注 EPA 或 DHA 对白细胞介素 (IL)-6 和肿瘤坏死因子 (TNF)-α 浓度的干预作用，需要进一步开展 RCT 以研究这些炎症因子。本荟萃分析提供了充分的证据表明，EPA 和 DHA 对慢性病危险因素具有独立（血压）和共同（CRP 浓度）的作用，应开展高质量的、多中心、大样本 RCT 以证实本研究结果。
