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Current Opinion in Lipidology Feb 2009Hypothesis-generating systematic review of the impact of marine-derived omega-3 polyunsaturated fatty acids (PUFAs) on lipid, glycemic and hematological risk factors in... (Meta-Analysis)
Meta-Analysis
PURPOSE OF REVIEW
Hypothesis-generating systematic review of the impact of marine-derived omega-3 polyunsaturated fatty acids (PUFAs) on lipid, glycemic and hematological risk factors in type 2 diabetes using pooled data from randomized controlled trials searched up to 20 September 2008.
RECENT FINDINGS
Seven new trials in 2007 and 2008 were identified from 206 abstracts to give a total of 24 trials between 1966 and 2008 involving 1533 participants that could be pooled. The mean omega-3 PUFAs dose and duration of treatment in the new trials was 2.4 g/day and 24 weeks, respectively. Compared with placebo, omega-3 PUFAs supplementation decreased triglycerides by 7% (mean -0.17 mmol/l, 24 trials, 1530 participants), fibrinogen by 10% (mean -0.96 micromol/l, three trials, 159 participants), ADP platelet aggregation to ADP by 22% (mean -10.30%, two trials, 64 participants) and to collagen by 21% (mean -10.55%, two trials, 64 participants), with an LDL-cholesterol increase of 3% (mean 0.08 mmol/l, 21 trials, 1104 participants). None of the following risk factors appeared to be beneficially influenced: HDL-cholesterol, LDL particle size, glycemia, insulinemia, inflammatory biomarkers, blood pressure. However for some of these risk factors (such as inflammatory biomarkers) the number of trial patients was small Higher doses of omega-3 PUFAs (>or=2 g/day) may have greater triglyceride lowering effects.
SUMMARY
This systematic review and meta-analysis confirms the triglyceride lowering effects of omega-3 PUFAs, demonstrates potential dose-response effects and shows improvements in thrombogenesis. Omega-3 PUFAs raise LDL levels without concomitant changes in lipid particle size. Changes seen in conventional risk factors are insufficient to explain the cardiovascular disease risk reductions suggested to occur with omega-3 PUFAs.
Topics: Cardiovascular Diseases; Clinical Trials as Topic; Diabetes Mellitus, Type 2; Dietary Supplements; Fatty Acids, Omega-3; Humans; Risk
PubMed: 19133409
DOI: 10.1097/mol.0b013e328321b3be -
Journal of Renal Nutrition : the... Mar 2008To study the effect of low-protein diet (LPD) on body composition (BC). (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To study the effect of low-protein diet (LPD) on body composition (BC).
STUDY DESIGN
A systematic review of the literature investigating BC during LPD treatment using total body potassium, dual energy X-ray absorptiometry, bioelectrical impedance analysis, and anthropometry.
PATIENTS
Studies reporting data of patients treated with LPD 0.3-0.75 g/kg/day and a renal function of glomerular filtration rate (GFR) < or =20 mL/min, creatinine clearance < or =25 mL/min, on serum creatinine > or =500 micromol/L were included in the review. Fourteen studies with a total number of 666 subjects were found eligible.
RESULTS
All studies except two concluded that treatment with LPD does not affect BC negatively. However, LPD should not be introduced in patients with a complicating disease, e.g., acidosis, septicaemia, and surgical treatment; neither should it be continued in patients who are unable to adhere to a diet prescription. Furthermore, LPD should be introduced with great caution in patients with an expected time to dialysis of < or =4 months due to an initial reduction of body weight and/or fat-free mass. Monitoring of treatment with LPD must be emphasized, including BC measurements and evaluation of protein and energy intake. These conclusions do not apply to patients with diabetes mellitus, because this diagnosis was excluded in a majority of reviewed studies.
CONCLUSION
There is no strong evidence that LPD impairs BC in patients with GFR < or =20 mL/min.
Topics: Absorptiometry, Photon; Adolescent; Adult; Aged; Anthropometry; Body Composition; Creatinine; Diet, Protein-Restricted; Dietary Proteins; Electric Impedance; Female; Glomerular Filtration Rate; Humans; Male; Middle Aged; Potassium
PubMed: 18267210
DOI: 10.1053/j.jrn.2007.08.006