Fish Oil and Glycemic Control in Diabetes: A meta-analysis

Friedberg, C. E.; Janssen, Marcel J.W.; Heine, Robert J.; Grobbee, Diederick E.

doi:10.2337/diacare.21.4.494

Cited by 257 publications

(151 citation statements)

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“…Our results are consistent with previous systematic reviews in patients with type 2 diabetes [9,56,57] and in the general population [1,15], showing that TG levels fall significantly after n-3 PUFA supplementation. After adjusting for HDL, increasing levels of TG have been shown to be an independent risk factor for cardiovascular disease in epidemiological studies [60], so lowering of TG levels may be an important therapeutic effect of n-3 PUFA supplementation in patients with type 2 diabetes.…”

Section: Discussionsupporting

confidence: 93%

“…TC levels were non-significantly lowered, similar to results of previous systematic reviews in type 2 diabetes [9,56,57] and in the general population [1], but were reduced in hypertriacylglycerolaemic patients [11]. HDL was non-significantly increased, as shown in previous systematic reviews of type 2 diabetes [9,56,57], in the general population and in type IIa hypercholesterolaemia patients [15]. The observed increase in LDL cholesterol was lower than previously reported [9,57].…”

Section: Discussionsupporting

confidence: 88%

“…After adjusting for HDL, increasing levels of TG have been shown to be an independent risk factor for cardiovascular disease in epidemiological studies [60], so lowering of TG levels may be an important therapeutic effect of n-3 PUFA supplementation in patients with type 2 diabetes. TC levels were non-significantly lowered, similar to results of previous systematic reviews in type 2 diabetes [9,56,57] and in the general population [1], but were reduced in hypertriacylglycerolaemic patients [11]. HDL was non-significantly increased, as shown in previous systematic reviews of type 2 diabetes [9,56,57], in the general population and in type IIa hypercholesterolaemia patients [15].…”

Section: Discussionsupporting

confidence: 87%

“…Three previous systematic reviews evaluated the effect of n-3 PUFA on cardiovascular events, lipid and glycaemic markers in type 2 diabetes [9,56,57]. However, we considered additional lipid, lipoprotein and apolipoprotein cardiovascular risk markers, and used changes in the mean from baseline to the end of the trial in the pooled analysis.…”

Section: Discussionmentioning

confidence: 99%

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Meta-analysis of the effects of n-3 polyunsaturated fatty acids on lipoproteins and other emerging lipid cardiovascular risk markers in patients with type 2 diabetes

et al. 2007

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Aims/hypothesis To determine the effects of marine-derived n-3 polyunsaturated fatty acids (PUFA) on established and emerging lipid and lipoprotein cardiovascular risk markers in patients with type 2 diabetes. Materials and methods We performed a systematic review and meta-analysis of randomised controlled trials comparing dietary or non-dietary intake of n-3 PUFA with placebo in patients with type 2 diabetes by searching databases from 1966 to December 2006. Changes in the following variables were recorded triacylglycerol; total cholesterol; HDL, LDL and VLDL and their subfractions; lipid ratios; apolipoproteins; and cholesterol particle sizes. Results There were 23 trials on non-dietary supplementation, involving 1,075 subjects with a mean treatment duration of 8.9 weeks, with sufficient data to permit pooling. Compared with placebo, n-3 PUFA had a statistically significant effect on four outcomes, reducing levels of (1) triacylglycerol (18 trials, 969 subjects) by 25% (mean 0.45 mmol/l; 95% CI −0.58 to −0.32; p<0.00001); (2) VLDL-cholesterol (7 trials, 238 subjects) by 36% (0.07 mmol/l; 95% CI −0.13 to 0.00; p=0.04); and (3) VLDL-triacylglycerol (6 trials, 178 subjects) by 39.7% (0.44 mmol/l; 95% CI −0.83 to −0.05; p= 0.03); while slightly increasing LDL (16 trials, 565 subjects) by 5.7% (0.11 mmol/l; 95% CI 0.00 to 0.22; p=0.05). There were no significant effects on total cholesterol, apolipoproteins, lipid subfractions or ratios. Conclusions/interpretation In addition to recognised triacylglycerol-lowering effects, n-3 PUFA supplementation decreases VLDL-cholesterol and VLDL-triacylglycerol, but may have an adverse effect on LDL-cholesterol. Larger and longer term clinical trials are required to conclusively establish the effect of n-3 PUFA on cardiovascular risk markers and outcomes in type 2 diabetic patients.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Meta-analysis of the effects of n-3 polyunsaturated fatty acids on lipoproteins and other emerging lipid cardiovascular risk markers in patients with type 2 diabetes

et al. 2007

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“…A recent review included patients with diabetes as part of a high-risk-group analysis, but also included non-randomised control trials [41]. There are three previous systematic reviews evaluating the effect of n-3 PUFA on cardiovascular events, lipid and glycaemic markers in type 2 diabetes [42][43][44], which found n-3 PUFA reduced triacylglycerol, modestly increased LDL-cholesterol, and had no significant effect on fasting glucose, HbA 1c , or total cholesterol and HDL-cholesterol. However, unlike previous systematic reviews, we also assessed the effects on other established and emerging cardiovascular risk factors.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2006

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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 nondietary 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-α, 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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Fish oil in people with type 2 diabetes mellitus

Farmer

Montori

Dinneen

et al. 2001

The Cochrane Database of Systematic Reviews

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Fish Oil and Glycemic Control in Diabetes: A meta-analysis

Abstract: The use of fish oil has no adverse affects on HbA1c in diabetic subjects and lowers triglyceride levels effectively by almost 30%. However, this may be accompanied by a slight increase in LDL cholesterol concentration. Fish oil may be useful in treating dyslipidemia in diabetes.

Cited by 257 publications

References 0 publications

Meta-analysis of the effects of n-3 polyunsaturated fatty acids on lipoproteins and other emerging lipid cardiovascular risk markers in patients with type 2 diabetes

Meta-analysis of the effects of n-3 polyunsaturated fatty acids on lipoproteins and other emerging lipid cardiovascular risk markers in patients with type 2 diabetes

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

Fish oil in people with type 2 diabetes mellitus

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