口服多不饱和脂肪酸补充剂的类型和剂量对炎症性风湿性疾病疾病活动的影响：系统文献回顾和荟萃分析。
Impact of type and dose of oral polyunsaturated fatty acid supplementation on disease activity in inflammatory rheumatic diseases: a systematic literature review and meta-analysis.
机构信息
Department of Rheumatology, Hôpital Avicenne, APHP, INSERM U1125, Université Sorbonne Paris Nord, 125 rue de Stalingrad, 93000, Bobigny, France.
Department of Rheumatology, CHU Gabriel-Montpied, Clermont-Ferrand, France.
出版信息
Arthritis Res Ther. 2022 May 7;24(1):100. doi: 10.1186/s13075-022-02781-2.
BACKGROUND
Polyunsaturated fatty acid (PUFA) supplementation has been reported to improve disease activity in inflammatory rheumatic diseases (IRDs). However, data are often conflicting and studies insufficiently large to draw conclusions. This systematic literature review and meta-analysis aimed to better estimate the effect of oral supplementation with omega (n)-3 and n-6 PUFA on IRD activity in terms of duration, dose, type, and source.
METHODS
The literature was searched in PubMed, EMBASE, and Cochrane Library databases up to October 2020. Studies were reviewed in accordance with PRISMA guidelines. The effect of PUFA supplementation on disease activity was expressed as the standardized mean difference (95% CI). Metaregression and subgroup analyses involved type of IRD, Jadad score, PUFA source (animal or vegetable), and doses.
RESULTS
We obtained 42 references; 30 randomized controlled studies were included comparing the effects of PUFA versus control on disease activity (710 IRD patients receiving PUFA supplementation and 710 controls, most with rheumatoid arthritis). We found a significant improvement in pain, swollen and tender joint count, Disease Activity Score in 28 joints, and Health Assessment Questionnaire score in IRD patients receiving PUFA supplementation as compared with controls, with a significant decrease in erythrocyte sedimentation rate but not C-reactive protein level. Although meta-regression revealed no difference by IRD type or source or dose of PUFA supplementation, subgroup analysis revealed more parameters significantly improved with animal- than vegetable-derived PUFAs and 3- to 6-month supplementation. Most studies examined high-dose supplementation (>2 g/day).
CONCLUSION
PUFA consumption, especially omega-3 from animal source >2 g/day, may improve IRD activity and might be an adjuvant therapy in rheumatoid arthritis.
TRIAL REGISTRATION
The protocol was registered at PROSPERO ( CRD42021253685 ).
背景
多不饱和脂肪酸（PUFA）补充已被报道可改善炎症性风湿病（IRDs）的疾病活动。然而，数据经常相互矛盾，且研究规模不足，无法得出结论。本系统文献综述和荟萃分析旨在更好地评估口服补充 ω（n）-3 和 n-6 PUFA 对 IRD 活性的影响，包括持续时间、剂量、类型和来源。
方法
检索 PubMed、EMBASE 和 Cochrane 图书馆数据库，截至 2020 年 10 月。研究按照 PRISMA 指南进行综述。PUFA 补充对疾病活动的影响表示为标准化均数差（95%CI）。荟萃回归和亚组分析包括 IRD 类型、Jadad 评分、PUFA 来源（动物或植物）和剂量。
结果
我们获得了 42 篇参考文献；30 项随机对照研究比较了 PUFA 与对照组对疾病活动的影响（710 例接受 PUFA 补充的 IRD 患者和 710 例对照组，大多数为类风湿关节炎）。我们发现，与对照组相比，接受 PUFA 补充的 IRD 患者疼痛、肿胀和压痛关节计数、28 关节疾病活动评分和健康评估问卷评分显著改善，红细胞沉降率显著降低，但 C 反应蛋白水平无差异。虽然荟萃回归显示 IRD 类型、来源或 PUFA 补充剂量无差异，但亚组分析显示，动物来源的 PUFA 与植物来源的 PUFA 相比，更多参数显著改善，且 3 至 6 个月的补充效果更好。大多数研究检查了高剂量补充（>2 g/天）。
结论
PUFA 摄入，尤其是动物源性 ω-3 大于 2 g/天，可能改善 IRD 活性，可能是类风湿关节炎的辅助治疗。
试验注册
该方案在 PROSPERO（CRD42021253685）上注册。
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