Department of Optometry and Vision Sciences, University of Melbourne, Parkville, Australia.
Department of Endocrinology and Diabetes, St Vincent's Hospital Melbourne, Fitzroy, Australia.
Nutr Rev. 2020 Apr 1;78(4):323-341. doi: 10.1093/nutrit/nuz054.
Peripheral nerve damage can occur in a variety of systemic conditions and can have a profound impact on functional and psychological health. Currently, therapeutic interventions for peripheral nerve damage are limited.
The aim of this systematic review, conducted in accordance with the Cochrane Collaboration's handbook and reported according to the PRISMA checklist, was to evaluate the efficacy and safety of omega-3 oral supplements for improving peripheral nerve structure and function.
PubMed, Embase, and Cochrane databases, along with clinical trial registries, were searched from inception to February 2019. Evidence was identified, critically appraised, and synthesized, and the certainty of evidence was appraised using the Grading of Recommendations Assessment, Development and Evaluation approach.
Randomized controlled trials assessing the effects of omega-3 oral supplementation on outcomes of peripheral nerve structure, peripheral nerve function, or both were eligible for inclusion. Titles and abstracts of identified articles were independently assessed for potential eligibility by 2 review authors. For studies judged as eligible or potentially eligible, full text articles were retrieved and independently assessed by 2 review authors to determine eligibility; disagreements were resolved by consensus.
Fifteen trials were included. Two clinically similar studies that investigated the effect of omega-3 supplementation in individuals receiving chemotherapy were meta-analyzed. Pooled data showed a reduced incidence of peripheral neuropathy (RR = 0.58; 95%CI, 0.43-0.77) and a preservation of sensory nerve action potential amplitudes with omega-3 supplementation compared with placebo (MD = 4.19 µV; 95%CI; 2.19-6.19).
This review finds, with low certainty, that omega-3 supplementation attenuates sensory loss and reduces the incidence of neuropathy secondary to oxaliplatin and paclitaxel treatment relative to placebo. There is currently limited evidence to ascertain whether omega-3 supplementation is beneficial in other systemic conditions characterized by peripheral nerve damage.
PROSPERO registration number CRD 42018086297.
外周神经损伤可发生于多种全身性疾病，并对功能和心理健康产生深远影响。目前，外周神经损伤的治疗干预措施有限。
本系统评价按照 Cochrane 协作手册进行，并根据 PRISMA 清单进行报告，旨在评估口服ω-3 补充剂改善外周神经结构和功能的疗效和安全性。
从建库至 2019 年 2 月，检索了 PubMed、Embase 和 Cochrane 数据库以及临床试验注册库。识别、批判性评价并综合证据，并使用推荐评估、制定与评价（GRADE）方法评估证据质量。
纳入评估ω-3 口服补充剂对外周神经结构、外周神经功能或两者影响的随机对照试验。由 2 位综述作者独立评估纳入研究的标题和摘要，以确定其是否符合纳入标准。对于被判定为符合或可能符合纳入标准的研究，检索全文并由 2 位综述作者独立评估以确定纳入标准；意见不一致时通过协商解决。
纳入了 15 项试验。对两项研究进行了荟萃分析，这两项研究均评估了ω-3 补充剂对接受化疗的个体的影响。汇总数据显示，与安慰剂相比，ω-3 补充剂可降低周围神经病变的发生率（RR = 0.58；95%CI，0.43-0.77），并维持感觉神经动作电位幅度（MD = 4.19 µV；95%CI；2.19-6.19）。
本系统评价发现，在较低的确定性水平下，与安慰剂相比，ω-3 补充剂可减轻奥沙利铂和紫杉醇治疗引起的感觉丧失，并降低周围神经病变的发生率。目前尚无足够证据确定ω-3 补充剂是否对其他以外周神经损伤为特征的全身性疾病有益。
PROSPERO 注册号 CRD 42018086297。
