Effects of Omega-3 Fatty Acid Supplementation on Glucose Control and Lipid Levels in Type 2 Diabetes: A Meta-Analysis

Cai, Chen; Yu, Xuefeng; Shao, Shiying

doi:10.1371/journal.pone.0139565

Cited by 104 publications

(97 citation statements)

References 42 publications

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“…Statins are generally first line therapy due to their ability to reduce cardiovascular morbidity and mortality in primary and secondary prevention and ezetimibe can be used in statin-intolerant individuals or as add on therapy (23, 24). For patients with isolated hypertriglyceridaemia, omega 3 fatty acid supplementation has been shown to be effective as shown in a meta-analysis including 20 randomized controlled studies ( n = 1,209 participants) that demonstrated individuals on supplements had triglyceride levels significantly decreased compared to controls (25). Fenofibrates and omega 3 fatty acid supplementation can be used alone or in combination, however care must be taken with fenofibrates if on statin therapy due to increased risk of skeletal toxicity (23, 24).…”

Section: Discussionmentioning

confidence: 99%

Benchmarks of Diabetes Care in Men Living With Treated HIV-Infection: A Tertiary Center Experience

2018

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Treated human immunodeficiency virus (HIV) infection is associated with high rates of type 2 diabetes mellitus (DM), metabolic syndrome and central obesity/body fat partitioning disorders. To our knowledge, there are no available data comparing diabetes care in people with both HIV+DM vs. DM alone (DM-controls) within the same service and evaluating if benchmarked standards of care are being met in people with HIV+DM. This study evaluated the frequency that people with HIV+DM met the benchmarked American Diabetes Association (ADA) standards of care in diabetes (targets for HbA1c, blood pressure, lipid levels, complication screening, and healthy weight), compared to age- and sex- matched controls with diabetes, in an urban teaching hospital. The frequency of diabetes complications and rates of obesity and metabolic syndrome were also examined. All participants were male; individuals with HIV+DM (n = 30) were similar to DM-controls (n = 30) for age, diabetes duration and smoking status, but were more frequently non-obese compared to DM controls (92 vs. 55%, respectively, p = 0.003). Only 41% of HIV+DM met HbA1c targets, compared with 70% of DM-controls (p = 0.037). Blood pressure targets were poorly met in both HIV+DM and DM-controls: 43 vs. 23%, respectively (p = 0.12); LDL cholesterol targets were met in 65 vs. 67% (p = 1.0). Benchmarked complication screening rates were similar between HIV+DM vs. DM-controls for annual foot examination (53 vs. 67%, respectively, p = 0.29); biennial retinal examination (83 vs. 77%, respectively, p = 0.52); and annual urinary albumin measurement (77 vs. 67%, respectively, p = 0.39). The prevalence of diabetes complications was similar between HIV+DM compared to DM-controls: macrovascular complications were present in 23% in both groups (p = 1.0); the prevalence of microvascular complications was 40 vs. 30%, respectively (p = 0.51). Achieving the standard of care benchmarks for diabetes in people with both HIV-infection and diabetes is of particular importance to mitigate against the accelerated cardiometabolic outcomes observed in those with treated HIV infection. HIV+DM were less likely to achieve HbA1c targets than people with diabetes, but without HIV. People with HIV+DM may require specific strategies to ensure care benchmarks are met.

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Section: Discussionmentioning

confidence: 99%

Benchmarks of Diabetes Care in Men Living With Treated HIV-Infection: A Tertiary Center Experience

2018

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“…A common comparison is that between studies undertaken in Asian countries vs. non-Asian ones. It has been reported that Asians showed a more marked decrease in the levels of TAGs in response to ϖ-3 fatty acids supplementation as compared to subjects within a USA/European group but, no significant differences were found for total cholesterol or BMI [157]. Flavonols have also been shown to significantly reduce TAGs, total and LDL-cholesterol in studies conducted in Asian countries as compared to those in the EU/European subgroup [7].…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of the Effects of Flavanol-Containing Tea, Cocoa and Apple Products on Body Composition and Blood Lipids: Exploring the Factors Responsible for Variability in Their Efficacy

et al. 2017

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Several randomized controlled trials (RCTs) and meta-analyses support the benefits of flavanols on cardiometabolic health, but the factors affecting variability in the responses to these compounds have not been properly assessed. The objectives of this meta-analysis were to systematically collect the RCTs-based-evidence of the effects of flavanol-containing tea, cocoa and apple products on selected biomarkers of cardiometabolic risk and to explore the influence of various factors on the variability in the responses to the consumption of these products. A total of 120 RCTs were selected. Despite a high heterogeneity, the intake of the flavanol-containing products was associated using a random model with changes (reported as standardized difference in means (SDM)) in body mass index (−0.15, p < 0.001), waist circumference (−0.29, p < 0.001), total-cholesterol (−0.21, p < 0.001), LDL-cholesterol (−0.23, p < 0.001), and triacylglycerides (−0.11, p = 0.027), and with an increase of HDL-cholesterol (0.15, p = 0.005). Through subgroup analyses, we showed the influence of baseline-BMI, sex, source/form of administration, medication and country of investigation on some of the outcome measures and suggest that flavanols may be more effective in specific subgroups such as those with a BMI ≥ 25.0 kg/m2, non-medicated individuals or by specifically using tea products. This meta-analysis provides the first robust evidence of the effects induced by the consumption of flavanol-containing tea, cocoa and apple products on weight and lipid biomarkers and shows the influence of various factors that can affect their bioefficacy in humans. Of note, some of these effects are quantitatively comparable to those produced by drugs, life-style changes or other natural products. Further, RCTs in well-characterized populations are required to fully comprehend the factors affecting inter-individual responses to flavanol and thereby improve flavanols efficacy in the prevention of cardiometabolic disorders.

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“…However, it should be noted that this is not a fully consistent finding, with the heterogeneity in responsiveness as yet not fully understood (9,10) . Consumption of EPA and DHA has also been shown to be associated with many other diseases, for example, autoimmune diseases such as rheumatoid arthritis, cancer, diabetes, respiratory diseases, gastrointestinal diseases, Alzheimer's disease, depression, as well as psychotic disorders, for example schizophrenia (11)(12)(13)(14) . The current recommended intakes for EPA plus DHA in the UK are ⩾450 mg/d (15) .…”

mentioning

confidence: 99%

The impact of fatty acid desaturase genotype on fatty acid status and cardiovascular health in adults

O’Neill

Minihane

2016

Proc. Nutr. Soc.

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The aim of this review was to determine the impact of the fatty acid desaturase (FADS) genotype on plasma and tissue concentrations of the long-chain (LC) n-3 PUFA, including EPA and DHA, which are associated with the risk of several diet-related chronic diseases, including CVD. In addition to dietary intakes, which are low for many individuals, tissue EPA and DHA are also influenced by the rate of bioconversion from α-linolenic acid (αLNA). Δ-5 and Δ-6 desaturase enzymes, encoded for by FADS1 and FADS2 genes, are key desaturation enzymes involved in the bioconversion of essential fatty acids (αLNA and linoleic acid (LA)) to longer chained PUFA. In general, carriers of FADS minor alleles tend to have higher habitual plasma and tissue levels of LA and αLNA, and lower levels of arachidonic acid, EPA and also to a lesser extent DHA. In conclusion, available research findings suggest that FADS minor alleles are also associated with reduced inflammation and CVD risk, and that dietary total fat and fatty acid intake have the potential to modify relationships between FADS gene variants and circulating fatty acid levels. However to date, neither the size-effects of FADS variants on fatty acid status, nor the functional SNP in FADS1 and 2 have been identified. Such information could contribute to the refinement and targeting of EPA and DHA recommendations, whereby additional LC n-3 PUFA intakes could be recommended for those carrying FADS minor alleles.

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Effects of Omega-3 Fatty Acid Supplementation on Glucose Control and Lipid Levels in Type 2 Diabetes: A Meta-Analysis

Cited by 104 publications

References 42 publications

Benchmarks of Diabetes Care in Men Living With Treated HIV-Infection: A Tertiary Center Experience

Benchmarks of Diabetes Care in Men Living With Treated HIV-Infection: A Tertiary Center Experience

A Systematic Review and Meta-Analysis of the Effects of Flavanol-Containing Tea, Cocoa and Apple Products on Body Composition and Blood Lipids: Exploring the Factors Responsible for Variability in Their Efficacy

The impact of fatty acid desaturase genotype on fatty acid status and cardiovascular health in adults

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