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孕期 ω-3 多不饱和脂肪酸干预对后代肥胖指标的影响:最新系统评价和荟萃分析。

The effectiveness of ω-3 polyunsaturated fatty acid interventions during pregnancy on obesity measures in the offspring: an up-to-date systematic review and meta-analysis.

机构信息

School of Health Sciences and Social Work (SHSSW), University of Portsmouth, James Watson West, 2 King Richard 1st Road, Portsmouth, PO1 2FR, UK.

Faculty of Health and Social Sciences, Bournemouth University, Poole, UK.

出版信息

Eur J Nutr. 2019 Oct;58(7):2597-2613. doi: 10.1007/s00394-018-1824-9. Epub 2018 Sep 24.

Abstract

BACKGROUND

The potential role of ω-3 long chain polyunsaturated fatty acid (LCPUFA) supplementation during pregnancy on subsequent risk of obesity outcomes in the offspring is not clear and there is a need to synthesise this evidence.

OBJECTIVE

A systematic review and meta-analysis of randomised controlled trials (RCTs), including the most recent studies, was conducted to assess the effectiveness of ω-3 LCPUFA interventions during pregnancy on obesity measures, e.g. BMI, body weight, fat mass in offspring.

METHODS

Included RCTs had a minimum of 1-month follow-up post-partum. The search included CENTRAL, MEDLINE, SCOPUS, WHO's International Clinical Trials Reg., E-theses and Web of Science databases. Study quality was evaluated using the Cochrane Collaboration's risk of bias tool.

RESULTS

Eleven RCTs, from ten unique trials, (3644 children) examined the effectiveness of ω-3 LCPUFA maternal supplementation during pregnancy on the development of obesity outcomes in offspring. There were heterogeneities between the trials in terms of their sample, type and duration of intervention and follow-up. Pooled estimates did not show an association between prenatal intake of fatty acids and obesity measures in offspring.

CONCLUSION

These results indicate that maternal supplementation with ω-3 LCPUFA during pregnancy does not have a beneficial effect on obesity risk. Due to the high heterogeneity between studies along with small sample sizes and high rates of attrition, the effects of ω-3 LCPUFA supplementation during pregnancy for prevention of childhood obesity in the long-term remains unclear. Large high-quality RCTs are needed that are designed specifically to examine the effect of prenatal intake of fatty acids for prevention of childhood obesity. There is also a need to determine specific sub-groups in the population that might get a greater benefit and whether different ω-3 LCPUFA, i.e. eicosapentaenoic (EPA) vs. docosahexanoic (DHA) acids might potentially have different effects.

摘要

背景

ω-3 长链多不饱和脂肪酸(LCPUFA)补充剂在妊娠期间对后代肥胖结局风险的潜在作用尚不清楚,需要综合评估这方面的证据。

目的

系统评价和荟萃分析随机对照试验(RCT),包括最近的研究,以评估妊娠期间 ω-3 LCPUFA 干预对肥胖指标的有效性,如 BMI、体重、后代体脂。

方法

纳入的 RCT 至少有 1 个月的产后随访。检索包括 Cochrane 图书馆、MEDLINE、SCOPUS、WHO 国际临床试验注册平台、E-theses 和 Web of Science 数据库。使用 Cochrane 协作风险偏倚工具评估研究质量。

结果

11 项 RCT(来自 10 项独特的试验),(3644 名儿童)研究了妊娠期间母体 ω-3 LCPUFA 补充对后代肥胖结局的影响。这些试验在样本、干预和随访类型和时间方面存在异质性。汇总估计表明,产前脂肪酸摄入与后代肥胖指标之间没有关联。

结论

这些结果表明,妊娠期间母体补充 ω-3 LCPUFA 对肥胖风险没有有益影响。由于研究之间存在高度异质性,以及样本量小、失访率高,因此妊娠期间补充 ω-3 LCPUFA 预防儿童肥胖的长期效果仍不清楚。需要进行大型高质量 RCT,专门研究产前脂肪酸摄入对预防儿童肥胖的影响。还需要确定人群中可能受益更大的特定亚组,以及不同的 ω-3 LCPUFA,即二十碳五烯酸(EPA)与二十二碳六烯酸(DHA)是否可能具有不同的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93b5/6769093/18db0a11b531/394_2018_1824_Fig1_HTML.jpg

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