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Meta-analysis of the effects of n-3 polyunsaturated fatty acids on haematological and thrombogenic factors in type 2 diabetes.

Abstract

AIM/HYPOTHESIS

To determine whether marine-derived n-3 polyunsaturated fatty acids (n-3 PUFA) (also known as omega-3 fatty acids) have beneficial effects on haematological and thrombogenic risk markers in addition to dyslipidaemia, in patients with type 2 diabetes.

METHODS

A systematic review and meta-analysis of randomised controlled trials comparing dietary or non-dietary intake of n-3 PUFA with placebo in type 2 diabetes was conducted by systematically searching databases from 1966 to February 2006. Changes in C-reactive protein, IL-6, TNF-alpha, platelet function, fibrinogen, factor VII, von Willebrand factor, endothelial function, heart rate and blood pressure were recorded. Inclusion of studies, data extraction and quality were assessed independently in duplicate.

RESULTS

Twelve trials involving 847 subjects with a mean treatment duration of 8.5 weeks included sufficient data to permit pooling. Compared with placebo, n-3 PUFA supplementation had a significant effect on two outcomes: reducing the level of diastolic blood pressure (five trials, 248 subjects) by a mean of 1.8 mm Hg (95% CI 0.0-3.6, p = 0.05) and increasing factor VII (two trials, 116 subjects) by 24.9% (95% CI 7.2-42.6, p = 0.006). There were no significant effects on systolic blood pressure, fibrinogen or heart rate.

CONCLUSIONS/INTERPRETATION

These results suggest that, in addition to the recognised effects on dyslipidaemia, n-3 PUFA decreases diastolic blood pressure, and appears to increase factor VII. Larger and more rigorously conducted clinical trials are required to establish conclusively the role of n-3 PUFA in cardiovascular risk markers and clinical outcomes in type 2 diabetes.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Division of Public Health and Primary Health Care, University of Oxford, Oxford, UK.

    , ,

    Source

    Diabetologia 50:2 2007 Feb pg 250-8

    MeSH

    Cardiotonic Agents
    Cardiovascular Diseases
    Clinical Trials as Topic
    Controlled Clinical Trials as Topic
    Diabetes Mellitus, Type 2
    Diabetic Angiopathies
    Fatty Acids, Omega-3
    Hematologic Diseases
    Humans
    Placebos
    Thrombosis

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Systematic Review

    Language

    eng

    PubMed ID

    17119918

    Citation

    Hartweg, J, et al. "Meta-analysis of the Effects of N-3 Polyunsaturated Fatty Acids On Haematological and Thrombogenic Factors in Type 2 Diabetes." Diabetologia, vol. 50, no. 2, 2007, pp. 250-8.
    Hartweg J, Farmer AJ, Holman RR, et al. Meta-analysis of the effects of n-3 polyunsaturated fatty acids on haematological and thrombogenic factors in type 2 diabetes. Diabetologia. 2007;50(2):250-8.
    Hartweg, J., Farmer, A. J., Holman, R. R., & Neil, H. A. (2007). Meta-analysis of the effects of n-3 polyunsaturated fatty acids on haematological and thrombogenic factors in type 2 diabetes. Diabetologia, 50(2), pp. 250-8.
    Hartweg J, et al. Meta-analysis of the Effects of N-3 Polyunsaturated Fatty Acids On Haematological and Thrombogenic Factors in Type 2 Diabetes. Diabetologia. 2007;50(2):250-8. PubMed PMID: 17119918.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Meta-analysis of the effects of n-3 polyunsaturated fatty acids on haematological and thrombogenic factors in type 2 diabetes. AU - Hartweg,J, AU - Farmer,A J, AU - Holman,R R, AU - Neil,H A W, Y1 - 2006/11/21/ PY - 2006/06/14/received PY - 2006/09/05/accepted PY - 2006/11/23/pubmed PY - 2007/9/27/medline PY - 2006/11/23/entrez SP - 250 EP - 8 JF - Diabetologia JO - Diabetologia VL - 50 IS - 2 N2 - AIM/HYPOTHESIS: To determine whether marine-derived n-3 polyunsaturated fatty acids (n-3 PUFA) (also known as omega-3 fatty acids) have beneficial effects on haematological and thrombogenic risk markers in addition to dyslipidaemia, in patients with type 2 diabetes. METHODS: A systematic review and meta-analysis of randomised controlled trials comparing dietary or non-dietary intake of n-3 PUFA with placebo in type 2 diabetes was conducted by systematically searching databases from 1966 to February 2006. Changes in C-reactive protein, IL-6, TNF-alpha, platelet function, fibrinogen, factor VII, von Willebrand factor, endothelial function, heart rate and blood pressure were recorded. Inclusion of studies, data extraction and quality were assessed independently in duplicate. RESULTS: Twelve trials involving 847 subjects with a mean treatment duration of 8.5 weeks included sufficient data to permit pooling. Compared with placebo, n-3 PUFA supplementation had a significant effect on two outcomes: reducing the level of diastolic blood pressure (five trials, 248 subjects) by a mean of 1.8 mm Hg (95% CI 0.0-3.6, p = 0.05) and increasing factor VII (two trials, 116 subjects) by 24.9% (95% CI 7.2-42.6, p = 0.006). There were no significant effects on systolic blood pressure, fibrinogen or heart rate. CONCLUSIONS/INTERPRETATION: These results suggest that, in addition to the recognised effects on dyslipidaemia, n-3 PUFA decreases diastolic blood pressure, and appears to increase factor VII. Larger and more rigorously conducted clinical trials are required to establish conclusively the role of n-3 PUFA in cardiovascular risk markers and clinical outcomes in type 2 diabetes. SN - 0012-186X UR - https://www.unboundmedicine.com/medline/citation/17119918/Meta_analysis_of_the_effects_of_n_3_polyunsaturated_fatty_acids_on_haematological_and_thrombogenic_factors_in_type_2_diabetes_ L2 - https://dx.doi.org/10.1007/s00125-006-0486-y DB - PRIME DP - Unbound Medicine ER -