Impact of omega‐3 supplementation on children and adolescents patients with cystic fibrosis: A systematic review and meta‐analysis of randomized‐controlled trials

Abstract

Objective: Clinical trial research have provided evidence that omega-3 may have larger potential benefits for treating cystic fibrosis (CF). This study's objective was to assess the impact of three supplementation on pediatric CF patients.Methods: Scopus, PubMed/Medline, Web of Science, Cochrane, and Embase databases were searched from commencement until July 20, 2022 using standard keywords to identify all randomized controlled studies (RCTs) examining the effects of omega-3 supplementation on young patients with CF. The eligible studies were subjected to a random-effects model meta-analysis.Results: A meta-analysis of 12 the eligible studies was performed. Findings of the study showed that omega-3 supplementation significantly increased the levels of docosahexaenoic acid (weighted mean [WMD]: 2.06%, 95% confidence interval [CI]:1.29, 2.82, p < 0.001) and eicosapentaenoic acid (WMD: 0.32%, 95% CI: 0.15, 0.48, p < 0.001) as well as decreased arachidonic acid (WMD: −0.78%, 95% CI: −1.50, −0.05, p = 0.035) and C-receptive protein (CRP) (WMD: −3.76 mg/L, 95% CI: −7.42, −0.10, p = 0.044) especially when used in higher doses and for a longer period of time compared to the control group. However, no significant effect was observed on other factors including forced expiratory volume 1, forced vital capacity as well as anthropometric parameters. In addition, high heterogeneity was reported for all fatty acids, but heterogeneity was low and nonsignificant for other variables. Conclusion:The finding showed that in pediatric patients with CF, omega-3 supplementation showed benefits only in plasma fatty acid profile and serum CRP.

Impact of 1-Year Supplementation with High-Rich Docosahexaenoic Acid (DHA) on Clinical Variables and Inflammatory Biomarkers in Pediatric Cystic Fibrosis: A Randomized Double-Blind Controlled Trial

“…On the other hand, changes in anthropometric variables with increases in body weight and height may be expected to occur in children during the growth phase of life, but these increases were greater in the group of DHA-treated participants with statistically significant differences as compared to those in the placebo group. On the contrary, in the analysis of the 12 RCTs included in the systematic review and meta-analysis of Sohouli et al [28], no significant effect of DHA supplementation on anthropometric parameters was observed.…”

“…Other studies using EPA, DHA, or combinations of EPA, DHA, and LA also reported improvements in lung function parameters [11,13,29,30], but differences in the characteristics of the populations (pediatric and adults), doses of omega-3 administered, and duration of supplementation make comparisons difficult. In a recent systematic review and meta-analysis of 12 RCTs of omega-3 supplementation in CF patients younger than 18 years [28], no significant effect on FEV or FVC was found, considering that the heterogeneity was low and insignificant for these two variables. On the other hand, we found a large variability in FEV 1 , FVC, and FEF 25-75 expressed as % predicted during the year prior to the study, as well as over the 1-year study period.…”

“…Randomized controlled trials (RCTs) of omega-3 supplementation in pediatric CF patients are scarce. In a recent systematic review and meta-analysis of the effect of omega-3 supplementation in children and adolescents, only 12 RCTs were selected [28]. Interestingly, the mean age ranged between 8.9 to 18 years and the percentage of males varied between 33.3% and 76.3%.…”

“…A larger study population and an extension of the supplementation period would likely have allowed for more consistent data concerning the clinical relevance of the use of DHA supplementation in pediatric CF patients. The strengths of the study include the design as a RCT and the characteristics of the DHA product, which is a highly concentrated DHA triglyceride that was patented as a cellular antioxidant compound, and which confers a higher effectiveness compared to other n-3 PUFA products that were analyzed in previous systematic reviews [14,15,28].…”