Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA.
Curr Diab Rep. 2019 Jan 25;19(2):6. doi: 10.1007/s11892-019-1126-5.
Summarize studies on omega-3 fatty acids in prevention of albuminuria in subjects with diabetes.
Several small, short-term trials suggested benefit on albuminuria in subjects with diabetes; however, results were not definitive. Welty et al. showed that eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) for 1 year slowed progression of early-stage albuminuria in subjects with diabetes with clinical coronary artery disease on an angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker, the majority of whom had an albumin/creatinine ratio (ACR) < 30 μg/mg. Moreover, significantly more (3-fold) subjects on EPA and DHA had a decrease in ACR compared to control, and three on EPA and DHA had a change in category from > 30 μg/mg to < 30 μg/mg, whereas no controls did. Potential mechanisms for benefit are discussed. These results suggest that there is benefit and perhaps even reversal of albuminuria with EPA and DHA at an early stage of disease in those with ACR < 30 μg/mg and those with microalbuminuria (ACR > 30).
总结关于ω-3 脂肪酸在预防糖尿病患者白蛋白尿中的作用的研究。
几项小型短期试验表明，ω-3 脂肪酸对糖尿病患者的白蛋白尿有一定益处；然而，结果并不明确。Welty 等人的研究表明，1 年内服用二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）可以延缓伴有临床冠状动脉疾病的糖尿病患者早期白蛋白尿的进展，这些患者正在服用血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂，其中大多数的白蛋白/肌酐比值（ACR）<30μg/mg。此外，与对照组相比，服用 EPA 和 DHA 的患者中有更多的人（3 倍）的 ACR 下降，而在 EPA 和 DHA 组中，有 3 人从 ACR>30μg/mg 变为<30μg/mg，而对照组则没有。讨论了潜在的获益机制。这些结果表明，在 ACR<30μg/mg 和微量白蛋白尿（ACR>30）的疾病早期，EPA 和 DHA 可能对白蛋白尿有益，甚至有逆转作用。
