Abstract
The purpose of this systematic review and meta-analysis was to investigate omega-3 fatty acids’ influence on 12 inflammatory biomarkers—LDL, HDL, total cholesterol, TG, HbA1c, Apo AI, Apo AII, Apo B, CRP, TNF-α, glucose, and fasting blood glucose among diabetic and cardiovascular disease (CVD) patients. We searched articles in six database engines, and 16 of the 696 articles reviewed met the inclusion criteria. Among these, lipid and inflammatory biomarkers investigated commonly included total cholesterol (11 studies), LDL, and TG (10 studies each). Overall, omega-3 was associated with a significant reduction in Apo AII among diabetic patients, as compared to different controls (−8.0 mg/dL 95% CI: −12.71, −3.29, p = 0.0009), triglycerides (−44.88 mg/dL 95% CI: −82.6, −7.16, p < 0.0001), HDL (−2.27 mg/dL 95% CI: −3.72, −0.83, p = 0.002), and increased fasting blood glucose (16.14 mg/dL 95% CI: 6.25, 26.04, p = 0.001). Omega-3 also was associated with increased LDL among CVD patients (2.10 mg/dL 95% CI: 1.00, 3.20, p = 0.0002). We conclude that omega-3 fatty acids may be associated with lower inflammatory biomarkers among diabetic and cardiovascular patients. Clinicians should be aware of these potential benefits; however, it is essential to recommend that patients consult with clinicians before any omega-3 intake.
Highlights
Elevated levels of several inflammation markers, such as C-reactive protein (CRP), fibrinogen, and various cytokines have been reported in cardiovascular disease (CVD) studies[4,5,6,7], and when these markers’ levels are reduced, CVD’s severity decreases[8]
We do not know yet omega-3 fatty acids’ precise effects on certain lipid profiles and inflammatory biomarkers among diabetic or CVD patients, which are the subject of this review
We excluded certain studies for the following reasons: the authors used the median or odds ratio (OR) (13 studies); no inflammatory biomarkers were used (4 studies); less than 1000 mg/day of omega-3 fatty acids was administered (3 studies); omega-3 fatty acids derived from alpha-linolenic acid were used (2 studies), or there were missing values (2 studies)
Summary
Elevated levels of several inflammation markers, such as C-reactive protein (CRP), fibrinogen, and various cytokines have been reported in CVD studies[4,5,6,7], and when these markers’ levels are reduced, CVD’s severity decreases[8]. One way to accomplish this is to use specialized immunoresolvents molecules, such as resolvins, lipoxins, protectins, and maresins, that mediate the www.nature.com/scientificreports resolution of inflammation[1,9,10] This approach helps the body return to homeostasis through active and highly regulated “programmed resolution”. The second includes resolvins and, more recently, protectins and maresins, which are derivatives of dietary omega-3 polyunsaturated fatty acids (PUFAs)[1,11,22,23,24] These molecules share similar pro-resolving characteristics to LX and receptor agonists[20,25], and provide a promising new approach to control inflammation by focusing on enhancing the “off signal” rather than inhibiting the “on signal”[25]. The PICOS were as follows: P (Population), diabetic or CVD patients; I (Interventions), any form of omega-3; C (Comparisons), any placebo control or a comparison group or diet; O (Outcomes), inflammatory biomarkers; and S (Study Design), randomized clinical trials
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