膳食二十碳五烯酸和二十二碳六烯酸补充对代谢综合征的影响：来自 33 项随机对照试验数据的系统评价和荟萃分析。
Effects of dietary eicosapentaenoic acid and docosahexaenoic acid supplementation on metabolic syndrome: A systematic review and meta-analysis of data from 33 randomized controlled trials.
机构信息
Institute of Nutrition & Health, College of Public Health, Qingdao University, Qingdao, China.
Institute of Nutrition & Health, College of Public Health, Qingdao University, Qingdao, China; College of Life Sciences, Qingdao University, Qingdao, China.
出版信息
Clin Nutr. 2021 Jul;40(7):4538-4550. doi: 10.1016/j.clnu.2021.05.025. Epub 2021 Jun 5.
BACKGROUND & AIMS: Previous randomized controlled trials (RCTs) have compared the effects of pure preparations of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in reducing metabolic syndrome (MetS) risk factors, but the results were inconsistent. The present study aimed to clarify whether EPA and DHA have differential effects on MetS features in humans.
METHODS
A systematic literature search was conducted in CNKI, PubMed, Embase and Scopus updated to February 2021. The mean changes in the characteristics of MetS were calculated as weighted mean differences by using a random-effects model. Thirty-three RCTs were included.
RESULTS
The results showed that both EPA and DHA were effective at lowering serum triglycerides (TG) levels. EPA supplementation decreased the serum levels of total cholesterol (TC) (WMD = -0.24 mmol/L; 95% CI, -0.43, -0.05 mmol/L), TG (WMD = -0.77 mmol/L; 95% CI, -1.54, -0.00 mmol/L) and low density lipoprotein-cholesterol (LDL-C) (WMD = -0.13 mmol/L; 95% CI, -0.25, -0.01 mmol/L), while DHA increased the serum levels of TC (WMD = 0.14 mmol/L; 95% CI, 0.03, 0.25 mmol/L), LDL-C (WMD = 0.26 mmol/L; 95% CI, 0.15, 0.38 mmol/L) and high density lipoprotein-cholesterol (HDL-C) (WMD = 0.07 mmol/L; 95% CI, 0.04, 0.09 mmol/L). Moreover, DHA increased the serum levels of insulin compared with EPA, especially in subgroups whose mean age was <60 years (0.43 mU/L; 95% CI: 0.04, 0.81 mU/L) and duration of DHA supplementation < 3 months (0.39 mU/L; 95% CI: 0.01, 0.77 mU/L).
CONCLUSIONS
The present meta-analysis provides evidence that EPA and DHA have different effects on risk factors of MetS.
背景与目的
先前的随机对照试验（RCTs）比较了二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）纯制剂对降低代谢综合征（MetS）风险因素的影响，但结果不一致。本研究旨在阐明 EPA 和 DHA 是否对人类 MetS 特征具有不同的影响。
方法
系统检索中国知网、PubMed、Embase 和 Scopus 数据库，检索时间截至 2021 年 2 月。采用随机效应模型计算 MetS 特征的平均变化作为加权均数差。共纳入 33 项 RCT。
结果
结果显示，EPA 和 DHA 均能有效降低血清三酰甘油（TG）水平。EPA 补充剂降低了血清总胆固醇（TC）（WMD=-0.24mmol/L；95%CI，-0.43，-0.05mmol/L）、TG（WMD=-0.77mmol/L；95%CI，-1.54，-0.00mmol/L）和低密度脂蛋白胆固醇（LDL-C）（WMD=-0.13mmol/L；95%CI，-0.25，-0.01mmol/L）水平，而 DHA 则增加了血清 TC（WMD=0.14mmol/L；95%CI，0.03，0.25mmol/L）、LDL-C（WMD=0.26mmol/L；95%CI，0.15，0.38mmol/L）和高密度脂蛋白胆固醇（HDL-C）（WMD=0.07mmol/L；95%CI，0.04，0.09mmol/L）水平。此外，与 EPA 相比，DHA 还增加了血清胰岛素水平，特别是在平均年龄<60 岁（0.43mU/L；95%CI：0.04，0.81mU/L）和 DHA 补充时间<3 个月（0.39mU/L；95%CI：0.01，0.77mU/L）的亚组中。
结论
本荟萃分析提供了证据表明，EPA 和 DHA 对 MetS 危险因素具有不同的影响。
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