Fatima Kaneez, Mahmood Aysal, Sayeed Faiza Zafar, Raza Maryam, Azam Rahima, Waris Nazish, Sattar Muttia Abdul, Rani Teesha, Wahaj Zainab, Kumar Danisha, Siddiqui Simra Nadeem
Dow University of Health Sciences (DUHS), Karachi, Sindh, Pakistan.
Department of Biochemistry, Baqai Medical College, Baqai Medical University, Karachi, Sindh, Pakistan.
SAGE Open Med. 2024 Sep 10;12:20503121241275467. doi: 10.1177/20503121241275467. eCollection 2024.
Hemodialysis patients with chronic kidney disease often exhibit inflammation characterized by elevated levels of C-reactive protein, Interleukin 6 and tumor necrosis factor-alpha, and they are shown to be associated with cardiovascular impairment and enhanced renal failure. This study aims to assess the impact of fish oil intake on inflammation indicators in adult hemodialysis patients.
From the inception to December 2023, the datasets Cochrane Central, Google Scholar, Science Direct, Embase, and Pubmed were examined. Two authors independently searched, selected, and screened the literature. The pooled results are represented by weighted mean difference (WMD) with 95% confidence intervals. To investigate the causes of heterogeneity, subgroup analysis was done. Sensitivity analysis was then used to evaluate the validity of the combined findings.
Thirteen randomized control trials studies were included. The pooled results showed that fish oil supplementation caused a significant reduction of the C-reactive protein level (WMD, -2.92 mg/L; 95% Confidence interval, -5.23, to -0.61; = 0.01; = 99%), especially in patients with baseline C-reactive protein ⩾5 mg/L (WMD, -4.39 mg/L; 95% Confidence interval, -5.93 to 2.85; < 0.00001; = 33%). Subgroup analyses showed that C-reactive protein baseline level (C-reactive protein <5 mg/L) was the main source of heterogeneity. Fish oil intake may not reduce the level of Interleukin 6 (WMD, -2.26; 95% Confidence interval: -19.61 to 15.09; = 0.80; = 93%), nor will it reduce the level of tumor necrosis factor-alpha (random model: WMD, -2.51; 95% Confidence interval: 6.08 to 1.06; = 0.17; = 98%).
Hemodialysis patients, especially those with C-reactive protein > 5 mg/L, responded to fish oil supplementation to reduce their C-reactive protein level; however, Interleukin 6 and tumor necrosis factor-alpha levels did not appear to be affected.
慢性肾脏病血液透析患者常表现出炎症反应，其特征为C反应蛋白、白细胞介素6和肿瘤坏死因子-α水平升高，且这些炎症反应与心血管功能损害及肾衰竭加剧有关。本研究旨在评估摄入鱼油对成年血液透析患者炎症指标的影响。
从研究开始至2023年12月，检索了Cochrane Central、谷歌学术、Science Direct、Embase和Pubmed数据集。两位作者独立进行文献检索、筛选和甄别。汇总结果以加权平均差（WMD）及95%置信区间表示。为探究异质性原因，进行了亚组分析。随后采用敏感性分析评估合并结果的有效性。
纳入了13项随机对照试验研究。汇总结果显示，补充鱼油可使C反应蛋白水平显著降低（WMD，-2.92mg/L；95%置信区间，-5.23至-0.61；P = 0.01；I² = 99%），尤其是基线C反应蛋白⩾5mg/L的患者（WMD，-4.39mg/L；95%置信区间，-5.93至-2.85；P < 0.00001；I² = 33%）。亚组分析表明C反应蛋白基线水平（C反应蛋白<5mg/L）是异质性的主要来源。摄入鱼油可能不会降低白细胞介素6水平（WMD，-2.26；95%置信区间：-19.61至15.09；P = 0.80；I² = 93%），也不会降低肿瘤坏死因子-α水平（随机模型：WMD，-2. .51；95%置信区间：-6.08至1.06；P = 0.17；I² = 98%）。
血液透析患者，尤其是C反应蛋白>5mg/L的患者，补充鱼油后C反应蛋白水平降低；然而，白细胞介素6和肿瘤坏死因子-α水平似乎未受影响。
