系统评价和荟萃分析随机对照试验，评估植物性 ω-3 多不饱和脂肪酸在非酒精性脂肪性肝病患者生物标志物和参数中的作用。
A systematic review and meta-analysis of randomized controlled trials to evaluate plant-based omega-3 polyunsaturated fatty acids in nonalcoholic fatty liver disease patient biomarkers and parameters.
机构信息
Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.
Manchester Royal Infirmary, Manchester, United Kingdom.
出版信息
Nutr Rev. 2024 Jan 10;82(2):143-165. doi: 10.1093/nutrit/nuad054.
CONTEXT
Nonalcoholic fatty liver disease (NAFLD) is prevalent in 25-30% of British and European populations, representing a potential global public health crisis. Marine omega-3 (n-3) polyunsaturated fatty acids offer well-evidenced benefits to NAFLD biomarkers; however, the effect of plant-based n-3 has not been evaluated with a systematic review and meta-analysis.
OBJECTIVE
The review aimed to systematically evaluate the effect of plant-based n-3 supplementation on NAFLD surrogate biomarkers and parameters.
DATA SOURCES
Medline (EBSCO), PubMed, CINAHL (EBSCO), Cochrane Central Register of Controlled Trials, the International Clinical Trials Registry Platform, and Google Scholar databases were searched to identify randomized controlled trials published between January 1970 and March 2022 evaluating the impact of plant-based n-3 interventions on diagnosed NAFLD. The review followed the PRISMA checklist and is PROSPERO registered (CRD42021251980).
DATA EXTRACTION
A random-effects model and generic inverse variance methods synthesized quantitative data, followed by a leave-one-out method for sensitivity analysis. We identified 986 articles; after the application of selection criteria, six studies remained with 362 patients with NAFLD.
RESULTS
The meta-analysis showed that plant-based n-3 fatty acid supplementation significantly reduced alanine aminotransferase (ALT) (mean difference: 8.04 IU/L; 95% confidence interval: 14.70, 1.38; I2 = 48.61%) and plasma/serum triglycerides (44.51 mg/dL; 95% confidence interval: -76.93, -12.08; I2 = 69.93%), alongside body-composition markers in patients with NAFLD (P < 0.05).
CONCLUSION
Plant-based n-3 fatty acid supplementation improves ALT enzyme biomarkers, triglycerides, body mass index, waist circumference, and weight loss when combined with lifestyle interventions to increase physical activity and a calorie-controlled diet. Further research is needed to identify the most effective plant-based n-3 sources in larger numbers of patients with NAFLD over longer study durations.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO registration no. CRD42021251980.
背景
非酒精性脂肪性肝病（NAFLD）在英国和欧洲人群中患病率为 25%-30%，代表着潜在的全球公共健康危机。海洋 ω-3（n-3）多不饱和脂肪酸对 NAFLD 生物标志物有很好的益处；然而，植物性 n-3 的效果尚未通过系统评价和荟萃分析进行评估。
目的
本综述旨在系统评估植物性 n-3 补充剂对 NAFLD 替代生物标志物和参数的影响。
数据来源
检索了 Medline（EBSCO）、PubMed、CINAHL（EBSCO）、Cochrane 对照试验中心注册库、国际临床试验注册平台和 Google Scholar 数据库，以确定 1970 年 1 月至 2022 年 3 月期间发表的评估植物性 n-3 干预对诊断为 NAFLD 的影响的随机对照试验。本综述遵循 PRISMA 清单，并在 PROSPERO 注册（CRD42021251980）。
数据提取
使用随机效应模型和通用逆方差方法综合定量数据，然后使用逐一剔除方法进行敏感性分析。我们共检索到 986 篇文章；在应用选择标准后，6 项研究纳入 362 例 NAFLD 患者。
结果
荟萃分析表明，植物性 n-3 脂肪酸补充剂可显著降低丙氨酸氨基转移酶（ALT）（平均差异：8.04IU/L；95%置信区间：14.70，1.38；I2=48.61%）和血浆/血清甘油三酯（44.51mg/dL；95%置信区间：-76.93，-12.08；I2=69.93%），同时改善 NAFLD 患者的身体成分标志物（P<0.05）。
结论
植物性 n-3 脂肪酸补充剂联合增加体力活动和热量控制饮食的生活方式干预可改善 ALT 酶生物标志物、甘油三酯、体重指数、腰围和体重减轻。需要进一步研究以确定在更长的研究时间内，在更多数量的 NAFLD 患者中最有效的植物性 n-3 来源。
系统评价注册
PROSPERO 注册号 CRD42021251980。
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