Omega-3, omega-6, and total dietary polyunsaturated fat for prevention and treatment of type 2 diabetes mellitus: systematic review and meta-analysis of randomised controlled trials
Brown TJ, Brainard J, Song F, Wang X, Abdelhamid A, Hooper L, PUFAH Group
BMJ (Clinical research ed.) · 191 citas
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
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- National Institutes of Health (AREDS2)
Según 22 financiadores declarados.
Publicación
- Publicado
- 2019-08-21 · BMJ · vol. 366 · pág. l4697
- Citado
- 320 citas · más que el 99% de estudios similares · 7.9× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 70 trabajos
- Acceso
- Acceso abierto (revista híbrida) · CC-BY-NC
- Áreas de investigación
- Fatty Acid Research and Health · Nutritional Studies and Diet · Diet and metabolism studies
- Palabras clave
- Medicine, Diabetes mellitus, Internal medicine, Confidence interval, Relative risk, Meta-analysis, Randomized controlled trial, Type 2 diabetes, Insulin resistance, Polyunsaturated fatty acid, Insulin, Endocrinology, Fatty acid, Chemistry, Biochemistry
- MeSH
- humans, diabetes mellitus, type 2, insulin resistance, insulin, blood glucose, dietary fats, unsaturated, fatty acids, omega-3, fatty acids, unsaturated, fatty acids, omega-6, fasting, primary prevention, dietary supplements, adult, female, male, randomized controlled trials as topic, secondary prevention, glycated hemoglobin
6 autores
- Tracey J. Brown
- Julii Suzanne Brainard
- Fujian Song🇬🇧University of East Anglia
- Xia Wang🇬🇧University of East Anglia
- Asmaa S Abdelhamid🇬🇧University of East Anglia
- Lee Hooper🇬🇧 · autor de correspondenciaUniversity of East Anglia
Resumen
El texto original del estudio, en el idioma en que se publicó.
Objective
To assess effects of increasing omega-3, omega-6, and total polyunsaturated fatty acids (PUFA) on diabetes diagnosis and glucose metabolism.
Design
Systematic review and meta-analyses.
Data sources
Medline, Embase, Cochrane CENTRAL, WHO International Clinical Trials Registry Platform, Clinicaltrials.gov, and trials in relevant systematic reviews.
Eligibility criteria
Randomised controlled trials of at least 24 weeks' duration assessing effects of increasing α-linolenic acid, long chain omega-3, omega-6, or total PUFA, which collected data on diabetes diagnoses, fasting glucose or insulin, glycated haemoglobin (HbA1c), and/or homoeostatic model assessment for insulin resistance (HOMA-IR).
Data synthesis
Statistical analysis included random effects meta-analyses using relative risk and mean difference, and sensitivity analyses. Funnel plots were examined and subgrouping assessed effects of intervention type, replacement, baseline risk of diabetes and use of antidiabetes drugs, trial duration, and dose. Risk of bias was assessed with the Cochrane tool and quality of evidence with GRADE.
Results
83 randomised controlled trials (mainly assessing effects of supplementary long chain omega-3) were included; 10 were at low summary risk of bias. Long chain omega-3 had little or no effect on likelihood of diagnosis of diabetes (relative risk 1.00, 95% confidence interval 0.85 to 1.17; 58 643 participants, 3.7% developed diabetes) or measures of glucose metabolism (HbA1c mean difference -0.02%, 95% confidence interval -0.07% to 0.04%; plasma glucose 0.04, 0.02 to 0.07, mmol/L; fasting insulin 1.02, -4.34 to 6.37, pmol/L; HOMA-IR 0.06, -0.21 to 0.33). A suggestion of negative outcomes was observed when dose of supplemental long chain omega-3 was above 4.4 g/d. Effects of α-linolenic acid, omega-6, and total PUFA on diagnosis of diabetes were unclear (as the evidence was of very low quality), but little or no effect on measures of glucose metabolism was seen, except that increasing α-linolenic acid may increase fasting insulin (by about 7%). No evidence was found that the omega-3/omega-6 ratio is important for diabetes or glucose metabolism.
Conclusions
This is the most extensive systematic review of trials to date to assess effects of polyunsaturated fats on newly diagnosed diabetes and glucose metabolism, including previously unpublished data following contact with authors. Evidence suggests that increasing omega-3, omega-6, or total PUFA has little or no effect on prevention and treatment of type 2 diabetes mellitus.
Systematic review registration
PROSPERO CRD42017064110.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial (CC BY-NC).
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