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Do ω-3 PUFAs affect insulin resistance in a sex-specific manner? A systematic review and meta-analysis of randomized controlled trials.
Am J Clin Nutr 2016; 104(5):1470-1484AJ

Abstract

BACKGROUND

Evidence has suggested that omega-3 (n-3) polyunsaturated fatty acids (PUFAs) improve obesity-induced insulin resistance (IR); however, results from human intervention trials have been equivocal. Recently it has been reported that n-3 PUFA status is inversely associated with type 2 diabetes in women but not in men, suggesting a sex-dependent effect.

OBJECTIVE

We aimed to determine whether n-3 PUFA interventions affect IR in a sex-dependent manner.

DESIGN

Five databases were searched (Medline, EMBASE, CINAHL, Scopus, and Pre-Medline) for randomized controlled trials. Searches were limited to the English language and to studies with adults aged >18 y. When possible, studies were pooled for a meta-analysis. The principle summary measure was the standardized mean difference (SMD) between groups.

RESULTS

Thirty-one eligible trials were identified with a total of 1848 participants [men: 45.1%; weighted mean ± SD age: 52.5 ± 8.2 y; weighted body mass index (in kg/m2): 28.8 ± 3.0]. Seven studies were conducted in women, 4 studies were conducted in men, and the remaining studies pooled men and women together. Twenty-six trials were pooled for the meta-analysis (men: n = 2; women: n = 6). With all studies (n = 26) pooled, there was no effect of n-3 PUFA on IR at the group level (SMD: 0.089; 95% CI: -0.105, 0.283; P = 0.367). In trials of ≥6 wk, a significant improvement in IR was seen in women (SMD: -0.266; 95% CI: -0.524, -0.007; P = 0.045) but not in men (SMD: 0.619; 95% CI: -0.583, 1.820; P = 0.313).

CONCLUSIONS

With this analysis, we provide preliminary evidence of a sex-dependent response of IR to an n-3 PUFA intervention. Additional studies are needed to confirm sex-dependent associations and to elucidate the potential mechanisms that are involved. This trial was registered at www.crd.york.ac.uk/PROSPERO/ as CRD42015017940.

Authors+Show Affiliations

Schools of Biomedical Sciences and Pharmacy and.Health Sciences, University of Newcastle, Callaghan, Australia; and.Schools of Biomedical Sciences and Pharmacy and.Department of Endocrinology, John Hunter Hospital, Hunter New England Local Health District, Newcastle, Australia.Schools of Biomedical Sciences and Pharmacy and manohar.garg@newcastle.edu.au.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

27680989

Citation

Abbott, Kylie A., et al. "Do Ω-3 PUFAs Affect Insulin Resistance in a Sex-specific Manner? a Systematic Review and Meta-analysis of Randomized Controlled Trials." The American Journal of Clinical Nutrition, vol. 104, no. 5, 2016, pp. 1470-1484.
Abbott KA, Burrows TL, Thota RN, et al. Do ω-3 PUFAs affect insulin resistance in a sex-specific manner? A systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr. 2016;104(5):1470-1484.
Abbott, K. A., Burrows, T. L., Thota, R. N., Acharya, S., & Garg, M. L. (2016). Do ω-3 PUFAs affect insulin resistance in a sex-specific manner? A systematic review and meta-analysis of randomized controlled trials. The American Journal of Clinical Nutrition, 104(5), pp. 1470-1484.
Abbott KA, et al. Do Ω-3 PUFAs Affect Insulin Resistance in a Sex-specific Manner? a Systematic Review and Meta-analysis of Randomized Controlled Trials. Am J Clin Nutr. 2016;104(5):1470-1484. PubMed PMID: 27680989.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Do ω-3 PUFAs affect insulin resistance in a sex-specific manner? A systematic review and meta-analysis of randomized controlled trials. AU - Abbott,Kylie A, AU - Burrows,Tracy L, AU - Thota,Rohith N, AU - Acharya,Shamasunder, AU - Garg,Manohar L, Y1 - 2016/09/28/ PY - 2016/05/11/received PY - 2016/08/24/accepted PY - 2016/11/3/pubmed PY - 2017/6/20/medline PY - 2016/9/30/entrez KW - DHA KW - EPA KW - adults KW - diabetes KW - insulin resistance KW - insulin sensitivity KW - omega-3 PUFAs SP - 1470 EP - 1484 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 104 IS - 5 N2 - BACKGROUND: Evidence has suggested that omega-3 (n-3) polyunsaturated fatty acids (PUFAs) improve obesity-induced insulin resistance (IR); however, results from human intervention trials have been equivocal. Recently it has been reported that n-3 PUFA status is inversely associated with type 2 diabetes in women but not in men, suggesting a sex-dependent effect. OBJECTIVE: We aimed to determine whether n-3 PUFA interventions affect IR in a sex-dependent manner. DESIGN: Five databases were searched (Medline, EMBASE, CINAHL, Scopus, and Pre-Medline) for randomized controlled trials. Searches were limited to the English language and to studies with adults aged >18 y. When possible, studies were pooled for a meta-analysis. The principle summary measure was the standardized mean difference (SMD) between groups. RESULTS: Thirty-one eligible trials were identified with a total of 1848 participants [men: 45.1%; weighted mean ± SD age: 52.5 ± 8.2 y; weighted body mass index (in kg/m2): 28.8 ± 3.0]. Seven studies were conducted in women, 4 studies were conducted in men, and the remaining studies pooled men and women together. Twenty-six trials were pooled for the meta-analysis (men: n = 2; women: n = 6). With all studies (n = 26) pooled, there was no effect of n-3 PUFA on IR at the group level (SMD: 0.089; 95% CI: -0.105, 0.283; P = 0.367). In trials of ≥6 wk, a significant improvement in IR was seen in women (SMD: -0.266; 95% CI: -0.524, -0.007; P = 0.045) but not in men (SMD: 0.619; 95% CI: -0.583, 1.820; P = 0.313). CONCLUSIONS: With this analysis, we provide preliminary evidence of a sex-dependent response of IR to an n-3 PUFA intervention. Additional studies are needed to confirm sex-dependent associations and to elucidate the potential mechanisms that are involved. This trial was registered at www.crd.york.ac.uk/PROSPERO/ as CRD42015017940. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/27680989/Do_ω_3_PUFAs_affect_insulin_resistance_in_a_sex_specific_manner_A_systematic_review_and_meta_analysis_of_randomized_controlled_trials_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.116.138172 DB - PRIME DP - Unbound Medicine ER -