Department of Gynecology and Obstetrics, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China.
Ann Palliat Med. 2021 Jun;10(6):6425-6437. doi: 10.21037/apm-21-1050.
There is a close relationship between cardiovascular risk factors and polycystic ovary syndrome (PCOS), and omega-3 fatty acids may have a key role in improving cardiovascular risk factors. We conducted the current systematic review and meta-analysis to evaluate the effect of omega-3 fatty acid supplementation on cardiovascular risk factors in patients with PCOS.
We searched 4 databases including PubMed (MEDLINE), Cochrane Library, Embase, and Web of Science from inception to February 2021. We included randomized controlled trials (RCTs) that reported the effects of omega-3 fatty acid treatment for PCOS. According to the Cochrane system evaluation guide manual, 2 researchers independently assessed the methodological quality of the included studies. We pooled results using either a fixed effect model or random effect model.
We identified 314 articles, of which 10 met the criteria for inclusion, involving 778 participants. The pooled results suggested an association between the supplementation of omega-3 fatty acids and a reduction in serum insulin [-2.58 pmol/L, 95% confidence interval (CI): -3.34 to -1.82 pmol/L, P<0.00001, I2=0], homeostatic model assessment of insulin resistance (HOMA-IR) (-0.57, 95% CI: -0.75 to -0.40 L, P<0.00001, I2=2%), serum total cholesterol (TC) (-6.87 mg/dL, 95% CI: -10.28 to -3.47 mg/dL, P<0.0001, I2=95%), serum triglyceride (-4.03 mg/dL, 95% CI: -5.53 to -2.52 mg/dL, P<0.00001, I2=97%), serum low-density lipoprotein cholesterol (LDL-C) (-6.64 mg/dL, 95% CI: -11.58 to -1.70 mg/dL, P=0.008, I2=99%), serum very low-density lipoprotein cholesterol (VLDL-C) (-3.29 mg/L, 95% CI: -6.54 to -0.05 mg/L, P=0.05, I2=72%), serum high-sensitivity C-reactive protein (hs-CRP) (-8.97mg/dL, 95% CI: -17.66 to -0.28 mg/dL, P=0.04, I2=99%), an improvement in serum high-density lipoprotein cholesterol (HDL-C) (2.94 mg/dL, 95% CI: 0.63 to 5.26 mg/dL, P=0.01, I2=87%), but no effect on serum glucose (-0.76 mg/dL, 95% CI: -1.71 to 0.19 mg/dL, P=0.12, I2=73%) was found.
The current meta-analysis demonstrated that omega-3 fatty acid supplementation for women with PCOS resulted in a statistical improvement in insulin, HOMA-IR, TC, triglyceride, LDL-C, VLDL-C, and HDL-C, but did not affect serum glucose. The limitation of this paper is due to the lack of included research literature.
心血管危险因素与多囊卵巢综合征（PCOS）密切相关，而ω-3 脂肪酸可能在改善心血管危险因素方面发挥关键作用。我们进行了本次系统评价和荟萃分析，以评估 ω-3 脂肪酸补充剂对 PCOS 患者心血管危险因素的影响。
我们从建库起至 2021 年 2 月在 4 个数据库（PubMed（MEDLINE）、Cochrane 图书馆、Embase 和 Web of Science）中进行了检索。我们纳入了报告 ω-3 脂肪酸治疗 PCOS 效果的随机对照试验（RCT）。根据 Cochrane 系统评价手册指南，2 位研究人员独立评估纳入研究的方法学质量。我们使用固定效应模型或随机效应模型汇总结果。
我们共检索到 314 篇文章，其中 10 篇符合纳入标准，涉及 778 名参与者。汇总结果表明，ω-3 脂肪酸补充与血清胰岛素降低相关[-2.58 pmol/L，95%置信区间（CI）：-3.34 至-1.82 pmol/L，P<0.00001，I²=0]，胰岛素抵抗稳态模型评估（HOMA-IR）[-0.57，95%CI：-0.75 至-0.40 L，P<0.00001，I²=2%]，血清总胆固醇（TC）[-6.87 mg/dL，95%CI：-10.28 至-3.47 mg/dL，P<0.0001，I²=95%]，血清甘油三酯[-4.03 mg/dL，95%CI：-5.53 至-2.52 mg/dL，P<0.00001，I²=97%]，血清低密度脂蛋白胆固醇（LDL-C）[-6.64 mg/dL，95%CI：-11.58 至-1.70 mg/dL，P=0.008，I²=99%]，血清极低密度脂蛋白胆固醇（VLDL-C）[-3.29 mg/L，95%CI：-6.54 至-0.05 mg/L，P=0.05，I²=72%]，血清高敏 C 反应蛋白（hs-CRP）[-8.97mg/dL，95%CI：-17.66 至-0.28 mg/dL，P=0.04，I²=99%]，血清高密度脂蛋白胆固醇（HDL-C）升高[2.94 mg/dL，95%CI：0.63 至 5.26 mg/dL，P=0.01，I²=87%]，但对血清葡萄糖没有影响[-0.76 mg/dL，95%CI：-1.71 至 0.19 mg/dL，P=0.12，I²=73%]。
本次荟萃分析表明，ω-3 脂肪酸补充剂可使 PCOS 患者的胰岛素、HOMA-IR、TC、甘油三酯、LDL-C、VLDL-C 和 HDL-C 得到统计学改善，但对血清葡萄糖无影响。本文的局限性在于纳入研究文献的缺乏。
