Atherosclerosis and Hypertension Research Group, Medical and Surgical Sciences Department, Sant'Orsola-Malpighi University Hospital, Building 2-IV Floor, Via Albertoni 15, 40138 Bologna, Italy.
Italian Nutraceutical Society (SINut), 40138 Bologna, Italy.
Mar Drugs. 2020 Jun 1;18(6):292. doi: 10.3390/md18060292.
Even though omega-3 polyunsaturated fatty acids (PUFAs) seem to be effective in the treatment of human immunodeficiency virus (HIV)-associated dyslipidemia, their impact is still debated. For this reason, our aim was to perform a meta-analysis of the clinical evidence available to date. A systematic literature search was conducted in order to identify published clinical trials assessing the effect of PUFAs treatment on serum lipoproteins, and its safety profile. The effect sizes for lipid changes were expressed as mean difference (MD) and 95% confidence interval (CI). For safety analysis, odd ratios and the 95% CI were calculated with the Mantel-Haenszel method. Data were pooled from nine clinical studies comprising overall 578 HIV-affected subjects. Meta-analysis of the data suggested that omega-3 PUFAs significantly reduced triglycerides (TG) (MD = -1.04, 95% CI: -1.5, -0.58 mmol/L, < 0.001), while increasing high-density lipoprotein cholesterol (MD = 0.36, 95% CI: 0.12, 0.61 mmol/L, = 0.004), without affecting serum levels of total cholesterol, very-low- and low-density lipoprotein cholesterol, and apolipoprotein B and A1. Change in TG was significantly associated with eicosapentaenoic acid administered via daily dose. PUFA treatment did not lead to an increased risk of adverse events. In conclusion, PUFAs are safe and exert a significant plasma lipid improving effect in HIV-positive patients.
尽管 ω-3 多不饱和脂肪酸（PUFA）似乎在治疗人类免疫缺陷病毒（HIV）相关血脂异常方面有效，但它们的作用仍存在争议。因此，我们的目的是对迄今为止可用的临床证据进行荟萃分析。系统地进行文献检索，以确定评估 PUFAs 治疗对血清脂蛋白及其安全性的已发表临床试验。血脂变化的效应大小表示为均数差（MD）和 95%置信区间（CI）。对于安全性分析，使用 Mantel-Haenszel 方法计算比值比和 95%CI。汇总了来自 9 项临床研究的数据，这些研究共包括 578 名 HIV 感染者。数据分析表明，ω-3 PUFAs 可显著降低甘油三酯（TG）（MD=-1.04，95%CI：-1.5，-0.58mmol/L，<0.001），同时增加高密度脂蛋白胆固醇（HDL-C）（MD=0.36，95%CI：0.12，0.61mmol/L，=0.004），而对总胆固醇、极低密度和低密度脂蛋白胆固醇以及载脂蛋白 B 和 A1 无影响。TG 的变化与每天给予的二十碳五烯酸显著相关。PUFA 治疗不会导致不良事件风险增加。总之，PUFAs 是安全的，并对 HIV 阳性患者的血浆脂质有显著的改善作用。
