Department of Public Health, Semmelweis University, Faculty of Medicine, Budapest, Hungary.
Department of Hematology and Stem Cell Transplantation, South Pest Central Hospital, National Institute for Haematology and Infectious Diseases, Budapest, Hungary.
Ann Palliat Med. 2022 Sep;11(9):2819-2829. doi: 10.21037/apm-22-254. Epub 2022 Aug 2.
The omega-3 polyunsaturated fatty acids (PUFAs) have an anti-inflammatory effect, beneficial for allergies, asthma, chronic obstructive pulmonary disease (COPD), reduce cholesterol and triglyceride levels and blood inflammatory parameters [C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-α)]. The aim of our cross-sectional study was to monitor omega-3 supplementation in patients with severe COPD and assess its association with quality of life, nutritional status, inflammatory parameters, lipid profile, comorbidities, exercise tolerance and inhaled medications.
Our questionnaire on dietary supplement habits and our validated self-completion questionnaires were filled in by 400 patients with COPD at the National Koranyi Institute of Pulmonology, Hungary, mean age 67 [61-73] years; forced expiratory volume in one second (FEV1) (ref%): 46 [34-58]; 47.5% male, 52.5% female. We used the disease-specific COPD Assessment Test (CAT) questionnaire to measure quality of life.
More than half of the study participants (61%) did not consume fish or oilseeds at all. Nineteen patients (4.75%) took omega-3 supplementation regularly, mainly on medical advice (0.5 g/day). We observed significantly lower serum CRP levels [6.0 (1-7.3) vs. 9.7 (7.4-14.4); P=0.044], more favourable lipid profile [triglycerides, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol] with higher mean body mass index (BMI) [28.1 (22.0-35.3) vs. 24.7 (24.5-30.1); P=0.118], better quality of life {CAT: 25 [21-30.5] vs. 26 [20-31]; P=0.519}, lower inhaled short-acting bronchodilators use [short-acting beta-agonists (SABAs): 6 (31.58) vs. 209 (54.86); P=0.047], lower number of exacerbations in the previous half year [0 (0-1) vs. 1 (0-2); P=0.023], and higher 6-minute walking distance (6MWD) {300 [177-387] vs. 251 [150-345]; P=0.120} in the group with omega-3 supplementation.
PUFAs are anti-inflammatory and affect the immune system. Our study shows that omega-3 intake of COPD patients is insufficient, and there is an urgent need to develop new anti-inflammatory strategies because only one drug (such as corticosteroids) cannot ease the chronically progressive inflammatory process of COPD.
ω-3 多不饱和脂肪酸（PUFAs）具有抗炎作用，对过敏、哮喘、慢性阻塞性肺疾病（COPD）有益，可降低胆固醇和甘油三酯水平以及血液炎症参数[C 反应蛋白（CRP）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、肿瘤坏死因子-α（TNF-α）]。我们这项横断面研究的目的是监测严重 COPD 患者的 ω-3 补充情况，并评估其与生活质量、营养状况、炎症参数、血脂谱、合并症、运动耐量和吸入药物的关系。
我们的饮食补充习惯问卷和我们验证过的自我完成问卷由匈牙利国家科拉尼肺科研究所的 400 名 COPD 患者填写，平均年龄 67[61-73]岁；用力呼气量一秒率（FEV1）（% 预计值）：46[34-58]；47.5%为男性，52.5%为女性。我们使用特定于疾病的 COPD 评估测试（CAT）问卷来衡量生活质量。
研究参与者中有一半以上（61%）根本不吃鱼或油籽。19 名患者（4.75%）定期服用 ω-3 补充剂，主要是根据医嘱（0.5 克/天）。我们观察到 CRP 血清水平显著降低[6.0（1-7.3）vs. 9.7（7.4-14.4）；P=0.044]，血脂谱更有利[甘油三酯、低密度脂蛋白（LDL）和高密度脂蛋白（HDL）胆固醇]，平均体重指数（BMI）更高[28.1（22.0-35.3）vs. 24.7（24.5-30.1）；P=0.118]，生活质量更好[CAT：25[21-30.5]vs. 26[20-31]；P=0.519]，使用吸入短效支气管扩张剂的次数更少[短效β-激动剂（SABA）：6（31.58）vs. 209（54.86）；P=0.047]，过去半年内加重的次数更少[0（0-1）vs. 1（0-2）；P=0.023]，6 分钟步行距离（6MWD）更长[300[177-387]vs. 251[150-345]；P=0.120]。
PUFAs 具有抗炎作用，并影响免疫系统。我们的研究表明，COPD 患者的 ω-3 摄入量不足，迫切需要制定新的抗炎策略，因为仅有一种药物（如皮质类固醇）无法缓解 COPD 的慢性进行性炎症过程。
