Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Adelaide, South Australia, Australia.
Adelaide Health Technology Assessment, School of Public Health, University of Adelaide, Adelaide, South Australia, Australia.
Am J Clin Nutr. 2022 Sep 2;116(3):672-685. doi: 10.1093/ajcn/nqac125.
Osteoarthritis (OA) is a major cause of chronic pain and disability worldwide. Treatment generally focuses on symptom relief through nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics, which may incur side effects. Krill oil, rich in anti-inflammatory long-chain (LC) omega-3 ( ω-3) PUFAs and astaxanthin, may be a safe and effective alternative treatment.
This study sought to investigate the effects of a commercially available krill oil supplement on knee pain in adults with mild to moderate knee OA. Secondary outcomes were knee stiffness; physical function; NSAID use; Omega-3 Index; and lipid, inflammatory, and safety markers.
Healthy adults (n = 235, 40-65 y old, BMI >18.5 to <35 kg/m2), clinically diagnosed with mild to moderate knee OA, regular knee pain, and consuming <0.5 g/d LC ω-3 PUFAs, participated in a 6-mo double-blind, randomized, placebo-controlled, multicenter trial. Participants consumed either 4 g krill oil/d (0.60 g EPA/d, 0.28 g DHA/d, 0.45 g astaxanthin/d) or placebo (mixed vegetable oil). Knee outcomes were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) numeric scale (normalized to scores of 0-100). Outcomes were assessed at baseline, 3 mo, and 6 mo.
Omega-3 Index increased with the krill oil supplement compared with placebo (from 6.0% to 8.9% compared with from 5.5% to 5.4%, P < 0.001). Knee pain score improved in both groups with greater improvements for krill oil than for placebo (difference in adjusted mean change between groups at 6 mo: -5.18; 95% CI: -10.0, -0.32; P = 0.04). Knee stiffness and physical function also had greater improvements with krill oil than with placebo (difference in adjusted mean change between groups at 6 mo: -6.45; 95% CI: -12.1, -0.9 and -4.67; 95% CI: -9.26, -0.05, respectively; P < 0.05). NSAID use, serum lipids, and inflammatory and safety markers did not differ between groups.
Krill oil was safe to consume and resulted in modest improvements in knee pain, stiffness, and physical function in adults with mild to moderate knee OA.This trial was registered at clinicaltrials.gov as NCT03483090.
骨关节炎（OA）是全球范围内导致慢性疼痛和残疾的主要原因。治疗方法通常侧重于通过非甾体抗炎药（NSAIDs）和镇痛药来缓解症状，但这些药物可能会产生副作用。富含抗炎长链（LC）ω-3（ω-3）多不饱和脂肪酸和虾青素的磷虾油可能是一种安全有效的替代治疗方法。
本研究旨在探讨市售磷虾油补充剂对轻中度膝骨关节炎成人膝关节疼痛的影响。次要结果是膝关节僵硬；身体功能；NSAID 使用；ω-3 指数；以及血脂、炎症和安全性标志物。
健康成年人（n=235，40-65 岁，BMI>18.5 至<35 kg/m2），临床诊断为轻至中度膝骨关节炎，经常出现膝关节疼痛，且每天摄入 LC ω-3 多不饱和脂肪酸<0.5 g，参加了一项为期 6 个月的双盲、随机、安慰剂对照、多中心试验。参与者每天服用 4 克磷虾油/d（0.60 克 EPA/d、0.28 克 DHA/d、0.45 克虾青素/d）或安慰剂（混合植物油）。使用 Western Ontario 和 McMaster 大学骨关节炎指数（WOMAC）数字量表（标准化为 0-100 分）评估膝关节结果。在基线、3 个月和 6 个月时评估结果。
与安慰剂相比，磷虾油补充剂使 ω-3 指数增加（从 6.0%增加到 8.9%，而安慰剂从 5.5%增加到 5.4%，P<0.001）。两组的膝关节疼痛评分均有所改善，磷虾油组的改善程度大于安慰剂组（6 个月时组间调整后平均变化差异：-5.18；95%CI：-10.0，-0.32；P=0.04）。膝关节僵硬和身体功能也随着磷虾油的使用而比安慰剂有更大的改善（6 个月时组间调整后平均变化差异：-6.45；95%CI：-12.1，-0.9 和-4.67；95%CI：-9.26，-0.05，分别；P<0.05）。两组间 NSAID 使用、血清脂质、炎症和安全性标志物无差异。
磷虾油安全可食用，可改善轻中度膝骨关节炎成人的膝关节疼痛、僵硬和身体功能。本试验在 clinicaltrials.gov 上注册为 NCT03483090。
