Department of General Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan.
Department of Emergency Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan.
Nutrients. 2022 Mar 16;14(6):1250. doi: 10.3390/nu14061250.
Numerous randomized controlled trials (RCTs) and meta-analyses have assessed the effects of supplemental dietary polyunsaturated fatty acids (PUFAs) on levels of low-density lipoprotein (LDL) and high-density lipoprotein (HDL) and the LDL/HDL ratio in patients receiving renal replacement therapy (RRT). However, results are ambiguous due to mixed reports of various nutrients used in the intervention group. We performed a network meta-analysis of RCTs to assess the effects of PUFAs on lipid profiles in patients undergoing RRT. RCTs performed before November 2021 were gathered from three databases. The means, standard deviations and the number of cases for each arm were independently extracted by two authors to form a network meta-analysis of LDL and HDL levels and the LDL/HDL ratio in a random effects model. Twenty-eight RCTs ( = 2017 subjects) were included in this study. The pooled results revealed that the combination of omega-3 fatty acids (n-3) and omega-6 fatty acids (n-6) produced significantly lower LDL (standardized mean difference (SMD) = -1.43, 95% confidence interval: -2.28 to -0.57) than the placebo. Both n-3 fatty acids (SMD = 0.78) and the combination of n-3 + n-6 (SMD = 1.09) benefited HDL significantly compared with placebo. Moreover, n-3 alone also exhibited a significantly lower LDL/HDL ratio than placebo. Collectively, PUFAs seem to be adequate nutrients for controlling lipoproteins in patients undergoing RRT. Specifically, n-3 + n-6 supplementation improved LDL levels, while n-3 improved HDL levels and the LDL/HDL ratio. However, our data provide limited information on specific dosages of PUFAs to form a concrete recommendation.
大量的随机对照试验（RCT）和荟萃分析评估了补充多不饱和脂肪酸（PUFA）对接受肾脏替代治疗（RRT）的患者的低密度脂蛋白（LDL）和高密度脂蛋白（HDL）水平以及 LDL/HDL 比值的影响。然而，由于干预组使用的各种营养素的报告不一致，结果仍存在争议。我们进行了一项 RCT 的网络荟萃分析，以评估 PUFAs 对接受 RRT 的患者血脂谱的影响。在 2021 年 11 月之前进行的 RCT 从三个数据库中收集。两位作者独立提取了每个组的平均值、标准差和病例数，以在随机效应模型中对 LDL 和 HDL 水平以及 LDL/HDL 比值进行网络荟萃分析。本研究共纳入 28 项 RCT（=2017 例）。汇总结果显示，ω-3 脂肪酸（n-3）和 ω-6 脂肪酸（n-6）联合使用与安慰剂相比，LDL 显著降低（标准化均数差（SMD）=-1.43，95%置信区间：-2.28 至-0.57）。与安慰剂相比，n-3 脂肪酸（SMD=0.78）和 n-3+n-6 联合使用（SMD=1.09）均显著提高了 HDL。此外，n-3 脂肪酸单独使用与安慰剂相比，LDL/HDL 比值也显著降低。总的来说，PUFAs 似乎是控制接受 RRT 的患者脂蛋白的合适营养素。具体而言，n-3+n-6 补充剂改善了 LDL 水平，而 n-3 则改善了 HDL 水平和 LDL/HDL 比值。然而，我们的数据提供了有限的关于 PUFAs 具体剂量的信息，无法形成具体的建议。
