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补充欧米伽-3脂肪酸对绝经后女性的血脂状况有有益影响吗?一项随机对照试验的系统评价和剂量反应荟萃分析。

Does Omega-3 Fatty Acid Supplementation Have Favorable Effects on the Lipid Profile in Postmenopausal Women? A Systematic Review and Dose-response Meta-analysis of Randomized Controlled Trials.

作者信息

Wang Junzhu, Gaman Mihnea-Alexandru, Albadawi Naryman Ismail, Salem Abdullah, Kord-Varkaneh Hamed, Okunade Kehinde S, Alomar Osama, Al-Badawi Ismail A, Abu-Zaid Ahmed

机构信息

The Big Data and Public Policy Lab in the School of Government, Peking University, Beijing, China.

Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania & Department of Hematology, Center of Hematology and Bone Marrow Transplantation, Fundeni Clinical Institute, Bucharest, Romania.

出版信息

Clin Ther. 2023 Jan;45(1):e74-e87. doi: 10.1016/j.clinthera.2022.12.009. Epub 2023 Jan 12.

Abstract

PURPOSE

Menopause is associated with disturbances in the metabolism of lipids. Moreover, during the postmenopausal period, female subjects are more prone to develop dyslipidemia. Omega-3 fatty acids, which exert cardioprotective, anti-inflammatory, and lipid-lowering actions, are commonly recommended in postmenopausal women. However, their effect on serum lipids in this population remains unclear. This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to clarify this research question.

METHODS

We systematically searched the Web of Science, Scopus, PubMed/MEDLINE, and EMBASE databases from their inception until January 3, 2022. The DerSimonian and Laird random-effects model was used to combine effect sizes.

FINDINGS

Omega-3 fatty acid supplementation resulted in a decrease in triglyceride concentrations (weighted mean difference [WMD], -17.8 mg/dL; 95% CI, -26 to -9.6; P < 0.001), particularly in the RCTs that lasted ≤16 weeks (WMD, -18.6 mg/dL), when the baseline triglyceride concentrations were ≥150 mg/dL (WMD, -22.8 mg/dL), in individuals with a body mass index ≥30 kg/m (WMD, -19.3 mg/dL), and when the dose of omega-3 fatty acids was ≥1 g/d (WMD, -21.10 mg/dL). LDL-C (WMD, 4.1 mg/dL; 95% CI, 1.80 to 6.36; P < 0.001) and HDL-C (WMD, 2.1 mg/dL; 95% CI, 0.97 to 3.2; P < 0.001) values increased. Total cholesterol levels (WMD, -0.15 mg/dL; 95% CI, -4 to 3.74; P = 0.94) remained unchanged after administration of omega-3 fatty acids.

IMPLICATIONS

In postmenopausal women, supplementation with omega-3 fatty acids resulted in a significant reduction in triglyceride concentrations and a modest elevation in HDL-C and LDL-C levels, whereas this intervention did not affect total cholesterol values.

摘要

目的

绝经与脂质代谢紊乱有关。此外,在绝经后期,女性受试者更容易发生血脂异常。ω-3脂肪酸具有心脏保护、抗炎和降血脂作用,通常被推荐用于绝经后女性。然而,它们对该人群血脂的影响仍不明确。本系统评价和随机对照试验(RCT)的荟萃分析旨在阐明这一研究问题。

方法

我们系统检索了Web of Science、Scopus、PubMed/MEDLINE和EMBASE数据库,检索时间从各数据库建库至2022年1月3日。采用DerSimonian和Laird随机效应模型合并效应量。

结果

补充ω-3脂肪酸可使甘油三酯浓度降低(加权平均差[WMD],-17.8mg/dL;95%CI,-26至-9.6;P<0.001),尤其是在持续时间≤16周的RCT中(WMD,-18.6mg/dL),基线甘油三酯浓度≥150mg/dL时(WMD,-22.8mg/dL),体重指数≥30kg/m²的个体中(WMD,-19.3mg/dL),以及ω-3脂肪酸剂量≥1g/d时(WMD,-21.10mg/dL)。低密度脂蛋白胆固醇(LDL-C)(WMD,4.1mg/dL;95%CI,1.80至6.36;P<0.001)和高密度脂蛋白胆固醇(HDL-C)(WMD,2.1mg/dL;95%CI,0.97至3.2;P<0.001)值升高。服用ω-3脂肪酸后总胆固醇水平(WMD,-0.15mg/dL;95%CI,-4至3.74;P=0.94)保持不变。

结论

在绝经后女性中,补充ω-3脂肪酸可显著降低甘油三酯浓度,适度提高HDL-C和LDL-C水平,而这种干预对总胆固醇值没有影响。

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