Omega-3 Fatty Acids In Patients Research Articles

Effects of hydrolyzed collagen alone or in combination with fish oil on the gut microbiome in patients with major burns

Burns are associated with gut dysbiosis. Collagen peptides and omega-3 fatty acids (FAs) are suggested to improve wound healing and the inflammatory response. These are also correlated with microbiome colonization. Therefore, the present study aimed to investigate the effect of hydrolyzed collagen alone or in combination with fish oil on specific species of the gut microbiome in patients with major burns. In this randomized double-blind clinical trial, 57 adults (aged 18–60 years) with 20–45% total body surface area burns were randomised into three groups to receive either 40 gr hydrolyzed collagen +10 ml sunflower oil, 40 g hydrolyzed collagen +10 ml fish oil or placebo, divided into two daily drinks, for two weeks. Gut bacteria were measured using the real-time quantitative polymerase chain reaction (qPCR) method. The mean concentration of Bifidobacterium was significantly reduced in the control (P = 0.002) and collagen (P = 0.005) groups compared with the baseline values, whereas no significant change was observed in the collagen omega-3 group. The Firmicutes to Bacteroidetes ratio decreased significantly in the collagen group (p = 0.002) after supplementation compared to baseline . No significant changes in concentration of Lactobacillus, Enterobacteriaceae, and F.prausnitzii were observed between or within the study groups. Two weeks of supplementation with collagen and omega-3 FAs in patients with major burns did not result in a significant difference in the concentration of bacteria measured between the study groups. However, the addition of omega-3 FAs prevented a significant reduction in gut Bifidobacterium. Future studies are suggested to investigate the potential efficacy of these nutrients in improving the gut microbiota and clinical outcomes in major burns. Registration numberIRCT20131125015536N9

Improved arterial inflammation with high dose omega-3 fatty acids in patients with elevated lipoprotein(a): Selective effect of eicosapentaenoic acid?

Elevated lipoprotein(a) [Lp(a)] is a causal risk factor for atherosclerotic cardiovascular disease. However, there are no approved and effective treatments for lowering Lp(a) and the associated cardiovascular risks. Omega-3 fatty acids (ω-3FAs), primarily eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have both triglyceride-lowering and anti-inflammatory properties. This pilot study investigated the effect of high dose ω-3FAs (3.6 g/day) on arterial inflammation in 12 patients with elevated Lp(a) (> 0.5 g/L) and stable coronary artery disease (CAD) receiving cholesterol-lowering treatment. Arterial inflammation was determined using 18F-fluorodexoyglucose positron emission tomography/computed tomography before and after 12-weeks intervention. ω-3FAs significantly lowered plasma concentrations of triglycerides (–17%, p < 0.01), Lp(a) (-5%, p < 0.01) as well as aortic maximum standardized uptake value (SUVmax) (–4%, p < 0.05). The reduction in SUVmax was significantly inversely associated with average on-treatment EPA (r = -0.750, p < 0.01), but not DHA and triglyceride, concentrations. In conclusion, high dose ω-3FAs decrease arterial inflammation in patients with elevated Lp(a) and stable CAD, which may involve a direct arterial effect of EPA.

Effects of acetylsalicylic acid alone or with omega-3 in patients with chronic coronary artery disease

Introduction and objectivesAntiplatelet agents such as acetylsalicylic acid (ASA) play a prominent role in preventing atherothrombosis. However, low-responsive patients who will not benefit from an increased dosage of this drug, which can cause bleeding and gastrointestinal irritation, need to be identified. Drugs such as omega-3 fatty acids, which enhance the vasodilating condition and diminish platelet aggregation, can potentiate the anti-aggregating effects of ASA, avoiding its side effects. Thus, we assessed the alternative use of 200mg/day of ASA and 100mg/day of this drug combined with 1g of omega-3 in 152 patients with chronic coronary artery disease. MethodsOur analysis included platelet function (ASPItest), TBX2 concentrations (ELISA), and SNPs polymorphisms in the rs3842787 and rs3842798 regions of the PTGS1 gene of the COX-1 enzyme and the rs5918 region of the ITGB3 gene of the fibrinogen's receptor subunit glycoprotein IIIa. ResultsASPItest detected 38 non-responders. The reduction of ASPItest values was more significant in this group than in responders and fell to levels of responders in non-responders of the 200mg/day treatment. A rare allele of rs3842787 is associated with a worse ASPItest response, and the rare allele of the rs5918 polymorphism with a worse response related to TBX2 concentration. Both treatments showed no statistically significant difference in hematuria or bleeding, constituting safe treatment alternatives, and omega-3 treatment reduced monocyte levels. ConclusionsOur results underscore the usefulness of pharmacogenetics for personalized treatments, avoiding gastrointestinal effects and undesirable bleeding.

Use of omega-3 as adjunctive therapy in the control of hyperlipidemia in metabolic and endocrine diseases in dogs

Omega-3 from fish is commonly recommended for the control of hyperlipidemia, however, there are few studies in dogs proving its efficacy, and no studies have compared doses of omega-3 in patients with severe hyperlipidemia.

Effects of an enteral nutrient-rich therapy with omega-3 fatty acids in patients with unresectable or recurrent biliary tract cancer or pancreatic cancer during chemotherapy: a case–control study

To evaluate omega-3 fatty acid-rich enteral nutrient effects in patients with unresectable or recurrent biliary tract or pancreatic cancers during chemotherapy. Enteric nutritional supplements containing omega-3 fatty acids (Racol®) was administered to aforementioned patients with cancers during chemotherapy. The skeletal muscle mass and blood test data were obtained pre-administration and 28 and 56 days after. Patients with pancreatic cancer were administered the digestive enzyme supplement pancrelipase (LipaCreon®) 28 days after the start of Racol® administration. The number of chemotherapies skipped due to neutropenia was recorded for 2 months before and after enteral nutrient initiation. In all 39 patients, the skeletal muscle mass increased on day 56 versus baseline (median 17.3 kg vs. 14.8 kg, p < 0.01), number of chemotherapies skipped decreased (mean: 0.65 times/month vs. 1.3 times/month, p = 0.03), and retinol-binding protein (mean: 2.56 mg/dL vs. 2.42 mg/dL, p = 0.05) increased. Patients with pancreatic cancer showed increased blood eicosapentaenoic acid concentration on day 56 versus baseline (median: 48.1 μg/mL vs. 37.0 μg/mL, p = 0.04) and increased skeletal muscle mass (median 16.8 kg vs. 14.4 kg, p = 0.006). Baseline median neutrophil count increased significantly from 2200/μL at baseline to 2500/μL (p = 0.04). Patients with biliary tract cancer during chemotherapy also exhibited increased skeletal muscle mass following omega-3 supplementation (median 17.3 kg vs. 15.8 kg, p = 0.01). In patients undergoing chemotherapy for unresectable or post-recurrence pancreatic and biliary tract cancers, high-omega-3 fatty acid nutrition therapy use improved skeletal muscle maintenance and chemotherapy dosing intensity.

Immunomodulatory Effects of Omega-3 Fatty Acids in Patients with Differentiated Thyroid Cancer Before or After Radioiodine Ablation.

Thyroid cancer and radioactive iodine (RAI) ablation for postsurgical management may lead to uncontrolled inflammation. This study was intended to assess the prophylactic and therapeutic immunomodulatory effects of omega-3 fatty acids in patients with differentiated thyroid cancer (DTC). A total of 85 patients with DTC were allocated into two groups based on RAI dosage after thyroidectomy. Patients in each group were randomly distributed into three subgroups: G1 with RAI ablation only, G2 treated with omega-3 for 30 days before RAI ablation, and G3 treated with omega-3 for 30 days after RAI ablation. Fifteen healthy individuals were included as controls. Serum cytokine levels including IL-2, IL-4, IL-5, IL-6, IL-9, IL-10, IL-13, IL-17A, IL-17F, IL-21, IL-22, TNF-α and IFN-γ were determined by cytometric bead assay. IL-4, IL-6, IL-21 and IL-22 levels in patients with DTC were higher than in the healthy controls. Regardless of RAI dosage, IL-6 showed an increasing trend after RAI ablation. IL-4, IL-22, and IL-17A remained at considerably higher levels than in the healthy controls after RAI ablation. Within-group comparisons showed a significant reduction in Th1+Th17/Th2+Th22 ratio in G2 patients 1 week after RAI ablation. Between-group comparisons showed increased IL-10 levels in G3 compared with G1 patients one week after high-dose RAI ablation. In G3, Th1+Th17/Th2+Th22 and Th1+Th17/Th2+Th9+Th22 ratios were remarkably lesser than in G2 patients 1 month after intermediate-dose RAI ablation. Our results showed better anti-inflammatory effects of omega-3 when it was used therapeutically after RAI ablation in patients with DTC than when it was used prophylactically before RAI.

The effect of plant-based omega-3 fatty acids in patients with non-alcoholic fatty liver disease. A systematic review and meta-analysis

The effect of plant-based omega-3 fatty acids in patients with non-alcoholic fatty liver disease. A systematic review and meta-analysis

Meta-Analysis of 19 Clinical Trials using Omega-3 Fatty Acids Indicate Distinct Outcomes for Icosapent Ethyl

<h3>Lead Author's Financial Disclosures</h3> Nothing to disclose. <h3>Study Funding</h3> None. <h3>Background/Synopsis</h3> Consumption of the omega-3 fatty acids (O3FAs) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) has been associated with a lower risk of cardiovascular disease (CVD). However, randomized clinical trials have failed to show consistent benefit with O3FAs in patients receiving contemporary medical care. Recent trials suggest that the formulation may have an important influence on clinical outcomes. <h3>Objective/Purpose</h3> We conducted a meta-analysis of 19 trials using both mixed O3FA products as well as prescription icosapent ethyl (IPE), which is the ethyl ester of EPA. <h3>Methods</h3> The current meta-analysis includes 15 randomized controlled trials with endpoints including non-fatal myocardial infarction (MI), coronary heart disease (CHD) death, total CHD, CVD death, total CVD, total stroke and major vascular events. The pooled rate ratios (RRs) were calculated using a fixed method. This meta-analysis also includes 4 clinical trials that assess the effect of O3FAs on coronary plaque volume and stability. All trials involved formulations with EPA alone (IPE) or in combination with DHA. <h3>Results</h3> Out of 19 trials using omega-3 fatty acids in patients with CVD risk, 5 of them employed IPE, all of which (100%) met the defined endpoints in statin treated patients. The remaining 14 trials used a combination of EPA and DHA. While only 4 (28%) met the defined endpoint, these trials with mixed O3FAs did not require statin use. <h3>Conclusions</h3> A meta-analysis of 19 CVD trials indicate that only IPE treatment was associated with reduced clinical events in statin-treated patients compared to mixed O3FAs. The basis for the distinct benefits of IPE are not fully understood but appear to be related to broad pleiotropic actions that correlate with on-treatment EPA levels. Elucidating such mechanisms for EPA will provide further insights into our understanding of CVD intervention.

META-ANALYSIS OF 17 CLINICAL TRIALS USING OMEGA-3 FATTY ACIDS IN PATIENTS WITH CARDIOVASCULAR DISEASE

BACKGROUND Cardiovascular disease (CVD) is the primary cause of mortality worldwide. Ischemic events associated with CVD are causatively related to vascular inflammation and atherothrombosis. Certain omega-3 fatty acids, such as eicosapentaenoic acid (EPA), are thought to have anti-inflammatory and anti-thrombotic properties. Icosapent ethyl (IPE) is an ethyl ester of EPA, currently approved by Health Canada as prescription IPE. At 4 g/d, IPE significantly reduced clinical events in high-risk patients with diabetes and other risk factors of CV disease in the REDUCE-IT trial. Previous clinical trials, with the majority of them administering a combination of EPA and the O3FA, docosahexaenoic acid (DHA), have been conducted with mixed outcomes. This study aimed to determine whether O3FA formulations of EPA alone versus mixed combinations can confer protection in patients with CVD. METHODS AND RESULTS The meta-analysis included 13 randomized controlled trials with endpoints including non-fatal myocardial infarction (MI), coronary heart disease (CHD) death, total CHD, CVD death, total CVD, total stroke and major vascular events. The pooled rate ratios (RRs) were calculated using a fixed method. This meta-analysis also included 4 clinical trials that assessed the effect of omega-3 fatty acids on coronary plaque volume and stability. All trials involved formulations with EPA alone or in combination with DHA. Out of 17 trials using omega-3 fatty acids in patients with CVD risk, 5 employed EPA alone, all of which (100%) met the defined endpoints. The remaining 12 trials used a combination of EPA and DHA, of which only 4 (33%) met the defined endpoints, but only in patients where statin use was not prespecified. The differences in outcomes did not correlate with triglyceride lowering. CONCLUSION In a meta-analysis of O3FA trials, the formulation of EPA alone as icosapent ethyl (IPE) was superior to mixtures containing DHA in statin-treated patients. The benefits with IPE are attributed to potential anti-inflammatory, anti-oxidant and anti-thrombotic actions. Elucidating such mechanisms for EPA will lead to further insights into our understanding of atherosclerosis and strategies for CVD treatment. Cardiovascular disease (CVD) is the primary cause of mortality worldwide. Ischemic events associated with CVD are causatively related to vascular inflammation and atherothrombosis. Certain omega-3 fatty acids, such as eicosapentaenoic acid (EPA), are thought to have anti-inflammatory and anti-thrombotic properties. Icosapent ethyl (IPE) is an ethyl ester of EPA, currently approved by Health Canada as prescription IPE. At 4 g/d, IPE significantly reduced clinical events in high-risk patients with diabetes and other risk factors of CV disease in the REDUCE-IT trial. Previous clinical trials, with the majority of them administering a combination of EPA and the O3FA, docosahexaenoic acid (DHA), have been conducted with mixed outcomes. This study aimed to determine whether O3FA formulations of EPA alone versus mixed combinations can confer protection in patients with CVD. The meta-analysis included 13 randomized controlled trials with endpoints including non-fatal myocardial infarction (MI), coronary heart disease (CHD) death, total CHD, CVD death, total CVD, total stroke and major vascular events. The pooled rate ratios (RRs) were calculated using a fixed method. This meta-analysis also included 4 clinical trials that assessed the effect of omega-3 fatty acids on coronary plaque volume and stability. All trials involved formulations with EPA alone or in combination with DHA. Out of 17 trials using omega-3 fatty acids in patients with CVD risk, 5 employed EPA alone, all of which (100%) met the defined endpoints. The remaining 12 trials used a combination of EPA and DHA, of which only 4 (33%) met the defined endpoints, but only in patients where statin use was not prespecified. The differences in outcomes did not correlate with triglyceride lowering. In a meta-analysis of O3FA trials, the formulation of EPA alone as icosapent ethyl (IPE) was superior to mixtures containing DHA in statin-treated patients. The benefits with IPE are attributed to potential anti-inflammatory, anti-oxidant and anti-thrombotic actions. Elucidating such mechanisms for EPA will lead to further insights into our understanding of atherosclerosis and strategies for CVD treatment.

Meta-analysis of 17 clinical trials using omega-3 fatty acids in patients with cardiovascular disease

Background and Aims: Increased fish oil consumption has been associated with a lower risk of cardiovascular disease (CVD). Fish oils owe their CVD benefits to omega-3 fatty acids which include eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Multiple clinical trials, with the majority of them administering a combination of EPA and DHA, have been conducted in Western and Asian populations with mixed outcomes. This study aimed to determine whether omega-3 fatty acid formulations of EPA alone versus mixed combinations can confer protection in patients with CVD.

ω-3 fatty acid alleviates virus-induced myocardial injury by regulating TLR4 and TLR3 expression

The specific pathogenesis of viral-induced myocardial injury is unclear. TLR regulation plays an important role in virus-induced myocardial injury. The therapeutic effect and possible mechanism of omega-3 fatty acids in patients with viral-induced myocardial injury must be investigated. The study population was randomly divided into three groups: a healthy control group (n = 50); general treatment group (n = 40); and general treatment with ω-3 polyunsaturated fatty acid group (n = 36). We detected the mRNA levels of TLR3 and TLR4, downstream signal pathway proteins, inflammatory factors, oxidative stress markers, and myocardial enzymes in patients and healthy controls. ω-3 fatty acid therapy in patients with virus-induced myocardial injury significantly regulates the expression of TLR3 and TLR4 and their downstream signal protein, increases antioxidant expression, reduces the secretion of inflammatory factors, alleviates myocardial injury, and improves cardiac function. This provides a new strategy to treat virus-induced myocardial injury.

Omega-3 fatty acid supplementation is associated with favorable outcomes in patients with sepsis: an updated meta-analysis.

ObjectivesThe efficacy of omega-3 fatty acids in the treatment of sepsis is controversial. We conducted an updated meta-analysis to clarify the efficacy of omega-3 fatty acids in patients with sepsis.MethodsPubMed, EMBASE, and the Cochrane Library were searched for randomized clinical trials (RCTs) on omega-3 fatty acid supplementation in adults with sepsis.ResultsTwenty eligible RCTs involving 1514 patients were included in the meta-analysis. Omega-3 fatty acid supplementation was linked to reductions of mortality (I2 = 0, relative risk [RR] = 0.82, 95% confidence interval [CI] = 0.69–0.97), the duration of mechanical ventilation (DMV; I2 = 74%, weighted mean difference [WMD] = −2.20, 95% CI = −4.00 to −0.40), and intensive care unit (ICU) length of stay (LOS; I2 = 91%, WMD = −3.86, 95% CI = −5.72 to −2.01). Subgroup analysis illustrated that mortality was significantly reduced in patients with sepsis and gastrointestinal dysfunction (RR = 0.5, 95% CI = 0.29–0.86, I2 = 0).ConclusionOmega-3 fatty acid supplementation might be associated with reduced mortality in patients with sepsis, especially those with gastrointestinal dysfunction. Furthermore, omega-3 fatty acid administration could shorten DMV and ICU LOS.

Effects of the re-esterified triglyceride (rTG) form of omega-3 supplements on dry eye following cataract surgery

Background/AimsTo evaluate the clinical outcomes of the systemic re-esterified triglyceride (rTG) form of omega-3 fatty acids in patients with dry eye symptoms after cataract surgery.MethodsThis prospective comparative cohort study comprised...

Efficacy of different doses of omega-3 fatty acids on cardiovascular outcomes: rationale and design of a network meta-analysis.

The impact of omega-3 fatty acids (O3FA) supplementation on cardiovascular risk is still in debate, largely due to the heterogeneity of population enrolled and variable dose and composition of the formulations used in the previous studies. Yet, O3FA may favorably impact on cardiovascular risk by reducing major cardiovascular events (including cardiac death and ischemic events). We aim to perform a comprehensive review of the topic of O3FA for cardiovascular prevention, stemming from a systematic review, to pairwise meta-analysis and network meta-analysis, limiting our inclusion only to randomized clinical trials comparing low dose (LD) (<1 g per day) O3FA and high dose (HD) (>1 g per day) O3FA versus placebo. The efficacy outcomes of interest are total death, cardiac death, sudden cardiac death, myocardial infarction, stroke, coronary revascularization, unstable angina and major vascular events. Safety outcomes of interest are bleeding, gastrointestinal disturbances and atrial fibrillation events. This meta-analysis is expected to include several important studies on cardiovascular primary and secondary prevention and detail on important cardiovascular outcomes. Furthermore, we intend to highlight safety outcomes related to O3FA supplementation. The present network meta-analysis results will aid physicians in the decision to prescribe O3FA in patients with or at risk of cardiovascular events. In particular, it will be able to solve controversies emerged from previous randomized clinical trials and meta-analyses regarding the benefit of different doses of O3FA supplementation in the cardiovascular prevention.

Efficacy and Safety of Omega-3 Fatty Acids in Patients Treated with Statins for Residual Hypertriglyceridemia: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

BackgroundCardiovascular risk remains increased despite optimal low density lipoprotein cholesterol (LDL-C) level induced by intensive statin therapy. Therefore, recent guidelines recommend non-high density lipoprotein cholesterol (non-HDL-C) as a secondary target for preventing cardiovascular events. The aim of this study was to assess the efficacy and tolerability of omega-3 fatty acids (OM3-FAs) in combination with atorvastatin compared to atorvastatin alone in patients with mixed dyslipidemia.MethodsThis randomized, double-blind, placebo-controlled, parallel-group, and phase III multicenter study included adults with fasting triglyceride (TG) levels ≥200 and <500 mg/dL and LDL-C levels <110 mg/dL. Eligible subjects were randomized to ATOMEGA (OM3-FAs 4,000 mg plus atorvastatin calcium 20 mg) or atorvastatin 20 mg plus placebo groups. The primary efficacy endpoints were the percent changes in TG and non-HDL-C levels from baseline at the end of treatment.ResultsAfter 8 weeks of treatment, the percent changes from baseline in TG (−29.8% vs. 3.6%, P<0.001) and non-HDL-C (−10.1% vs. 4.9%, P<0.001) levels were significantly greater in the ATOMEGA group (n=97) than in the atorvastatin group (n=103). Moreover, the proportion of total subjects reaching TG target of <200 mg/dL in the ATOMEGA group was significantly higher than that in the atorvastatin group (62.9% vs. 22.3%, P<0.001). The incidence of adverse events did not differ between the two groups.ConclusionThe addition of OM3-FAs to atorvastatin improved TG and non-HDL-C levels to a significant extent compared to atorvastatin alone in subjects with residual hypertriglyceridemia.

Pharmacokinetics of omega-3 fatty acids in patients with severe sepsis compared with healthy volunteers: A prospective cohort study

Pharmacokinetics (PK) of pharmaceuticals and pharmaconutrients are poorly understood in critically ill patients, and dosing is often based on healthy subject data. This might be particularly problematic with enteral medications due to metabolic abnormalities and impaired gastrointestinal tract absorption common in critically ill patients. Utilizing enteral fish oil, this study was undertaken to better understand and define PK of enteral omega-3 fatty acids (eicospentaenoic acid [EPA] and docosahexaenoic acid [DHA]) in critically ill patients with severe sepsis. Healthy volunteers (n=15) and mechanically ventilated (MV) adults with severe sepsis (n=10) were recruited and received 9.75g EPA and 6.75g DHA daily in two divided enteral doses of fish oil for 7 days. Volunteers continued their normal diet without other sources of fish oil, and sepsis patients received standard enteral feeding. Blood was collected at frequent intervals during the 14-day study period. Peripheral blood mononuclear cells (PMBCs) and neutrophils were isolated and analyzed for membrane fatty acid (FA) content. Mixed linear models and t-tests were used to analyze changes in FA levels over time and FA levels at individual time points, respectively. PK parameters were obtained based on single compartment models of EPA and DHA kinetics. Healthy volunteers were 41.1±10.3 years; 67% were women. In patients with severe sepsis (55.6±13.4 years, 50% women), acute physiologic and chronic health evaluation (APACHE) II score was 27.2±8.8at ICU admission and median MV duration was 10.5 days. Serum EPA and DHA were significantly lower in sepsis vs. healthy subjects over time. PBMC EPA concentrations were generally not different between groups over time, while PBMC DHA was higher in sepsis patients. Neutrophil EPA and DHA concentrations were similar between groups. The half-life of EPA in serum and neutrophils was significantly shorter in sepsis patients, whereas other half-life parameters did not vary significantly between healthy volunteers and sepsis patients. While incorporation of n-3 FAs into PBMC and neutrophil membranes was relatively similar between healthy volunteers and sepsis patients receiving identical high doses of fish oil for one week, serum EPA and DHA were significantly lower in sepsis patients. These findings imply that serum concentrations and EPA and DHA may not be the dominant driver of leukocyte membrane incorporation of EPA and DHA. Furthermore, lower serum EPA and DHA concentrations suggest that either these n-3 FAs were being metabolized rapidly in sepsis patients or that absorption of enteral medications and pharmaconutrients, including fish oil, may be impaired in sepsis patients. If enteral absorption is impaired, doses of enteral medications administered to critically ill patients may be suboptimal.

Omega-3 and -6 fatty acid plasma levels are not associated with liver cirrhosis-associated systemic inflammation.

BackgroundLiver cirrhosis is associated with profound immunodysfunction, i.e. a parallel presence of chronic systemic inflammation and immunosuppression, which can result in acute-on-chronic liver failure (ACLF). Omega-3 fatty acids are precursors of pro-resolving mediators and support the resolution of inflammation.ObjectiveThe aim of this study was to determine plasma levels of omega-3 fatty acids in patients with liver cirrhosis and ACLF.MethodsPatients with liver cirrhosis with and without ACLF were enrolled in a prospective cohort study and analyzed post-hoc for the present sub-study. Clinical data and biomaterials were collected at baseline and at day 7, 28 and after 3 months of follow-up. Plasma concentrations of arachidonic acid (ARA) and docosahexaenoic acid (DHA), which represent key omega-6 and -3 fatty acids, respectively, were quantified and associated with markers of systemic inflammation and severity of liver cirrhosis.ResultsA total of 117 patients were included in the present analyses. Of those, 26 (22.2%), 51 (43.6%) and 40 (34.2%) patients had compensated or decompensated liver cirrhosis, and ACLF. Plasma levels of ARA and DHA were similar in patients with compensated cirrhosis, decompensated cirrhosis, and ACLF. Furthermore, no significant association between plasma ARA or DHA and C-reactive protein or peripheral blood leukocytes were observed (P>0.05).ConclusionIn our study plasma levels of key omega-3 and omega-6 fatty acid are neither associated with the severity of liver cirrhosis nor with liver-cirrhosis-associated systemic inflammation.

Antioxidant Supplement Improves the Pregnancy Rate in Patients Undergoing &amp;lt;i&amp;gt;in Vitro&amp;lt;/i&amp;gt; Fertilization for Unexplained Infertility

Objective: This is a retrospective study to evaluate the effect of using the antioxidants containing coenzyme Q10 (CoQ10) and omega-3 in patients undergoing in vitro fertilization and intracytoplasmic sperm injection (IVF-ICSI) for unexplained infertility. Materials Methods: A total of 299 patients undergoing IVF-ICSI for unexplained infertility at the IVF center of Ondokuz Mayis University were studied. The subject group consisted of 135 patients who used OMEPA Q10 (Co Q10 100 mg, omega-3 600 mg, eicosapentaenoic acid 300 mg, docosahexaenoic acid 230 mg) for two months before ovarian stimulation. A group of 164 patients who did not use the supplement were evaluated as the control group. Results: The pregnancy rate of patients using antioxidants was statistically higher than that of those who did not use the supplement (p < 0.05). The pregnancy rates of patients in the two groups were 32.9% and 49.6% respectively. The pregnancy rate of patients using antioxidants was statistically higher than that of those who did not use the supplement (p < 0.05) seemed not enough. Conclusion: We concluded that using antioxidants that contain Co Q10 and omega-3 in patients undergoing IVF-ICSI for unexplained infertility increased the clinical pregnancy rate. We recommend using antioxidants that contain Co Q10 and omega-3 in infertile patients.

The omega-3 index in patients with heart failure: A prospective cohort study

BackgroundEpidemiologic studies on the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in heart failure are scarce, while one large intervention trial demonstrated a modest benefit. MethodsThis is a secondary analysis from the Interdisciplinary Network Heart Failure (INH) program. Patients hospitalized for systolic heart failure were enrolled and followed for 36 months. At baseline, whole blood samples from 899 patients were analyzed for fatty acid composition using a standardized analytical procedure (HS-Omega-3 Index®, O3-I). Associations of the O3-I with markers of heart failure severity, clinical characteristics, biomarkers, and mortality were analyzed. ResultsThe mean O3-I was 3.7 ± 1.0%. Patient mean age was 68 ± 12 years (72% male, 43% in New York Heart Association (NYHA) class III or IV, mean LVEF 30 ± 8%). During follow-up 258 patients (28.7%) died. After adjustment for potential confounders, the O3-I showed weak associations with uncured malignancy, end-systolic diameter of the left atrium, left ventricular end-diastolic and end-systolic diameters, and blood lipids and other laboratory parameters (all p < 0.05), but not with NYHA class, left ventricular ejection fraction, and the underlying cause of heart failure. The O3-I did not predict the 3-year mortality risk. ConclusionsOur results show a marked depletion of omega-3 fatty acids in patients hospitalized for decompensated heart failure (suggested target range 8–11%). Although the O3-I was associated with a panel of established risk indicators in heart failure, it did not predict mortality risk. Clinical Trial Registrationwww.controlled-trials.com; ISRCTN23325295

Systematic review and meta-analysis of controlled intervention studies on the effectiveness of long-chain omega-3 fatty acids in patients with nonalcoholic fatty liver disease.

ContextTreatment options for nonalcoholic fatty liver disease (NAFLD) are needed.ObjectiveThe aim of this review was to systematically assess the effects of omega-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFAs), particularly eicosapentaenoic acid and docosahexaenoic acid, on liver-related and metabolic outcomes in adult and pediatric patients with NAFLD.Data SourcesThe online information service ProQuest Dialog was used to search 8 literature databases.Study SelectionControlled intervention studies in which the independent effects of n-3 LC-PUFAs could be isolated were eligible for inclusion.Data ExtractionThe 18 unique studies that met the criteria for inclusion were divided into 2 sets, and data transcriptions and study quality assessments were conducted in duplicate. Each effect size was expressed as the weighted mean difference and 95%CI, using a random-effects model and the inverse of the variance as a weighting factor.ResultsBased on the meta-analyses, supplementation with n-3 LC-PUFAs resulted in statistically significant improvements in 6 of 13 metabolic risk factors, in levels of 2 of 3 liver enzymes, in liver fat content (assessed via magnetic resonance imaging/spectroscopy), and in steatosis score (assessed via ultrasonography). Histological measures of disease [which were assessed only in patients with nonalcoholic steatohepatitis (NASH)] were unaffected by n-3 LC-PUFA supplementation.ConclusionsOmega-3 LC-PUFAs are useful in the dietary management of patients with NAFLD. Additional trials are needed to better understand the effects of n-3 LC-PUFAs on histological outcomes in patients with NASH. Systematic Review RegistrationPROSPERO CRD42017055951.