Abstract
BackgroundPrevious studies did not draw a consistent conclusion about the effects of marine-derived n-3 polyunsaturated fatty acids (PUFAs) on fasting blood level of C-reactive protein (CRP), interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α).Methods and FindingsA comprehensive search of Web of Science, PubMed, Embase and Medline (from 1950 to 2013) and bibliographies of relevant articles was undertaken. Sixty-eight RCTs with a total of 4601 subjects were included in the meta-analysis. Marine-derived n-3 PUFAs supplementation showed a lowering effect on Marine-derived n-3 PUFAs supplementation had a significant lowering effect on TNF-α, IL-6 and CRP in three groups of subjects (subjects with chronic non-autoimmune disease, subjects with chronic autoimmune disease and healthy subjects). A significant negative linear relationship between duration and effect size of marine-derived n-3 PUFAs supplementation on fasting blood levels of TNF-α and IL-6 in subjects with chronic non-autoimmune disease was observed, indicating that longer duration of supplementation could lead to a greater lowering effect. A similar linear relationship was also observed for IL-6 levels in healthy subjects. Restricted cubic spline analysis and subgroup analysis showed that the lowering effect of marine-derived n-3 PUFAs on CRP, IL-6 and TNF-α in subjects with chronic non-autoimmune disease became weakened when body mass index was greater than 30 kg/m2. The effect of marine-derived n-3 PUFAs from dietary intake was only assessed in subjects with chronic non-autoimmune disease, and a significant lowering effect was observed on IL-6, but not on CRP and TNF-α.ConclusionsMarine-derived n-3 PUFAs supplementation had a significant lowering effect on CRP, IL-6 and TNF-α level. The lowering effect was most effective in non-obese subjects and consecutive long-term supplementation was recommended.
Highlights
Previous studies have shown that inflammation plays an important role in numerous chronic diseases, such as cardiovascular disease (CVD), diabetes, obesity-related diseases, and autoimmune diseases [1,2,3,4]
A significant linear relationship was observed between effect size on C-reactive protein (CRP) and daily dose of eicosapentaenoic acid (EPA), and the coefficient was 20.195 (Figure 17), indicating that higher doses of EPA could lead to a greater lowering effect, and the percentage of change with one unit increase of EPA dose (g/d) was 217.72%; no significant linear relationship was observed between effect size on CRP and other continuous confounding variables
The significant linear relationship between duration and effect size demonstrated that marine-derived n-3 polyunsaturated fatty acids (PUFAs) supplementation had a significant lowering effect on interleukin 6 (IL-6) in healthy subjects the pooled effect size was only marginally significant
Summary
Previous studies have shown that inflammation plays an important role in numerous chronic diseases, such as cardiovascular disease (CVD), diabetes, obesity-related diseases, and autoimmune diseases (e.g., rheumatoid arthritis) [1,2,3,4]. The process involves increased production of inflammatory factors, such as Creactive protein (CRP), tumor necrosis factor a (TNF-a) and interleukin 6 (IL-6). Previous studies have shown a significant association between CRP and obesity [8,9]. Previous studies did not draw a consistent conclusion about the effects of marine-derived n-3 polyunsaturated fatty acids (PUFAs) on fasting blood level of C-reactive protein (CRP), interleukin 6 (IL-6) and tumor necrosis factor a (TNF-a)
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