补充n-3多不饱和脂肪酸对2型糖尿病患者心血管指标的影响：一项随机对照试验的荟萃分析
Effects of n-3 Polyunsaturated Fatty Acid Supplementation on Cardiovascular Indices in Type 2 Diabetes: A Meta-analysis of Randomized Controlled Trials.
作者信息
Li Ruiyao, Wang Yao, Xu Jing, Yu Jiahao, Li Bin
机构信息
School of Clinical Medicine, Shandong Second Medical University, 261053 Weifang, Shandong, China.
School of Clinical Medicine, Shandong First Medical University, 250117 Jinan, Shandong, China.
出版信息
Rev Cardiovasc Med. 2025 Feb 18;26(2):25882. doi: 10.31083/RCM25882. eCollection 2025 Feb.
BACKGROUND
Individuals with type 2 diabetes (T2DM) face a significantly increased risk of cardiovascular disease. This study aims to explore the impact of omega-3 polyunsaturated fatty acids (n-3 PUFAs) on cardiovascular indices in this population. Although the benefits of n-3 PUFAs on cardiovascular health and glycemic outcomes are highly regarded, previous research reports have shown inconsistent results. Therefore, a comprehensive meta-analysis is needed to gain a deeper understanding of the specific effects of n-3 PUFAs on patients with T2DM. To examine the effect of n-3 PUFAs on cardiovascular indices in T2DM using a meta-analysis of randomized controlled trials (RCTs).
METHODS
Online databases including PUBMED, EMBASE and Cochrane libraries were searched up to December 2023. We assessed the overall weighted mean difference in cardiovascular indices between the group supplemented with n-3 PUFAs and the control group. The differences were compared uniformly using pre- and post-treatment differences.
RESULTS
Supplementation with n-3PUFAs in patients diagnosed solely with T2DM significantly reduced low density lipoprotein (LDL) (weighted mean difference (WMD) = -3.92, 95% confidence interval (CI) = -6.52 to -1.32, = 0.003 < 0.05), triglycerides (WMD = -23.94, 95% CI = -34.95 to -12.93, = 0.000 < 0.05), cholesterol (WMD = -8.39, 95% CI = -12.06 to -4.72, = 0.000 < 0.05), glycated hemoglobin (WMD = -0.25, 95% CI = -0.41 to -0.06, = 0.003 < 0.05) and the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index (WMD = -0.55, 95% CI = -0.81 to -0.29, = 0.000 < 0.05). All other differences in lipid indices, glycemic indices, inflammatory parameters and blood pressure were not statistically significant ( > 0.05). Supplementation with n-3 PUFAs decreased high density lipoprotein (HDL) concentration in patients with T2DM and coronary heart disease (CHD) (WMD = -3.92, 95% CI = -6.36 to -1.48, = 0.002 < 0.05). There were no significant differences in LDL, triglycerides, cholesterol, and C-reactive protein (CRP) in patients with T2DM and CHD ( > 0.05).
CONCLUSIONS
N-3 PUFAs improved lipid levels and long-term blood glucose levels in patients diagnosed solely with T2DM, but did not significantly improve blood pressure inflammatory markers. N-3 PUFAs showed no significant improvement in blood lipid and inflammatory indexes in patients with T2DM and CHD.
THE PROSPERO REGISTRATION
CRD42024522262, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024522262.
背景
2型糖尿病（T2DM）患者面临心血管疾病风险显著增加。本研究旨在探讨ω-3多不饱和脂肪酸（n-3 PUFAs）对该人群心血管指标的影响。尽管n-3 PUFAs对心血管健康和血糖结局的益处备受关注，但既往研究报告结果并不一致。因此，需要进行全面的荟萃分析，以更深入了解n-3 PUFAs对T2DM患者的具体影响。通过对随机对照试验（RCT）进行荟萃分析，研究n-3 PUFAs对T2DM患者心血管指标的影响。
方法
检索截至2023年12月的在线数据库，包括PUBMED、EMBASE和Cochrane图书馆。我们评估了补充n-3 PUFAs组与对照组之间心血管指标的总体加权平均差异。使用治疗前后差异统一比较这些差异。
结果
仅诊断为T2DM的患者补充n-3 PUFAs可显著降低低密度脂蛋白（LDL）（加权平均差异（WMD）=-3.92，95%置信区间（CI）=-6.52至-1.32，P=0.003<0.05）、甘油三酯（WMD=-23.94，95%CI=-34.95至-12.93，P=0.000<0.05）、胆固醇（WMD=-8.39，95%CI=-12.06至-4.72，P=0.000<0.05）、糖化血红蛋白（WMD=-0.25，95%CI=-0.41至-0.06，P=0.003<0.05）以及胰岛素抵抗稳态模型评估（HOMA-IR）指数（WMD=-0.55，95%CI=-0.81至-0.29，P=0.000<0.05）。脂质指标（P>0.05）、血糖指标、炎症参数和血压的所有其他差异均无统计学意义。T2DM合并冠心病（CHD）患者补充n-3 PUFAs会降低高密度脂蛋白（HDL）浓度（WMD=-3.92，95%CI=-6.
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