Abstract
BackgroundEffect of fish oil supplementation on flow-mediated dilation, an index of endothelial function in humans, remains controversial. We performed a meta-analysis to determine whether fish oil supplementation could improve endothelial function.MethodsHuman intervention studies were identified by systematic searches of Medline, Embase, Cochrane's library and references of related reviews and studies. A random-effect model was applied to estimate the pooled results. Meta-regression and subgroup analyses were performed to evaluate the impact of study characteristics on the effect of fish oil supplementation on flow-mediated dilation.ResultsA total of sixteen records with 1,385 subjects were reviewed. The results of the pooled analysis showed that fish oil supplementation significantly improved flow-mediated dilation (weighed mean difference: 1.49%, 95% confidence interval 0.48% to 2.50%, p = 0.004). Meta-regression and subgroup analysis suggested that the quality of included studies were inversely related to the overall effect (regression coefficient = −1.60, p = 0.04), and the significance of the effect was mainly driven by the studies with relatively poor quality. Sensitivity analysis including only double-blind, placebo-controlled studies indicated fish oil supplementation has no significant effect on endothelial function (weighed mean difference: 0.54%, 95% confidence interval −0.25% to 1.33%, p = 0.18). Besides, normoglycemic subjects or participants with lower diastolic blood pressure seemed to be associated with remarkable improvement of endothelial function after fish oil supplementation.ConclusionsAlthough current evidence suggested a possible role of fish oil in improving endothelial function, large-scale and high-quality clinical trials are needed to evaluate these effects before we can come to a definite conclusion.
Highlights
Accumulating evidence from epidemiological studies and clinical trials have suggested that increased intake of non-fried fish or supplementation with fish oil is associated with lower risk of cardiovascular mortality, indicating a potential role of fish oil supplementation in the primary and secondary prevention of cardiovascular diseases (CVD) [1,2]
Twentyone records were excluded because endothelial function was not measured by flow-mediated dilation (FMD) in 13 records; only data of postprandial FMD were reported in 4 records; fish oil was supplemented for,3 days in 3 records; and because fasting FMD data were unavailable in one record
Study characteristics Overall, a total of 23 studies from 16 published articles were included in the current meta-analysis, which comprised a total of 1385 participants, 707 subjects in the fish oil group and 678 patients in the control group
Summary
Accumulating evidence from epidemiological studies and clinical trials have suggested that increased intake of non-fried fish or supplementation with fish oil is associated with lower risk of cardiovascular mortality, indicating a potential role of fish oil supplementation in the primary and secondary prevention of cardiovascular diseases (CVD) [1,2]. A cross-sectional study has suggested that dietary fish or fish oil consumption may be associated with enhanced FMD in women [12], results of prospective randomized controlled trials evaluating the effect of fish oil supplementation on FMD, a surrogate of endothelial function, are generally controversial [13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28], partly due to the small number of included participants. Effect of fish oil supplementation on flow-mediated dilation, an index of endothelial function in humans, remains controversial. We performed a meta-analysis to determine whether fish oil supplementation could improve endothelial function
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