Impact of omega-3 fatty acids on diabetic nephropathy

  • Chewcharat A & al.
  • PLoS ONE
  • 1 Jan 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • In patients with type 2 diabetes mellitus (T2DM), omega-3 fatty acids could ameliorate proteinuria who received omega-3 supplementation for at least 24 weeks without affecting haemoglobin A1c (HbA1c) level, total serum cholesterol, and low-density lipoprotein-cholesterol (LDL-C) level.
  • No significant difference change in estimated glomerular filtration rate (eGFR) was observed between omega-3 fatty acids and placebo.

Why this matters

  • Markers of oxidative stress, inflammation and urine protein fingerprinting reflecting severity of glomerular or tubulointerstitial injury should be evaluated to address the potential mechanism of omega-3 fatty acids on delaying proteinuria.

Study design

  • 10 randomised controlled trials (RCTs; n=344) met eligibility criteria after a search across electronic databases.
  • Funding: None disclosed.

Key results

  • Omega-3 fatty acids vs placebo group had significant reduction in the risk for proteinuria in patients with T2DM (standardised mean difference [SMD], −0.29; 95% CI, −0.54 to −0.03; P=.03) but not in type 1 diabetes mellitus (SMD, 0.01; 95% CI, −0.36 to 0.38; P=.95).
  • Studies with follow-up ≥24 weeks showed a lower risk for proteinuria in omega-3 fatty acids vs control group in patients with T2DM (SMD, −0.30; 95% CI, −0.58 to −0.02; P=.04).
  • Both patients with T1DM and T2DM in omega-3 fatty acids vs placebo group had a higher eGFR but was not significant (weighted mean difference [WMD], 1.56mL/min/1.73m2; 95% CI, −1.53 to 4.65; P=.32).
  • Omega-3 fatty acids vs control groups did not differ in:
    • total cholesterol (WMD, 3.72 mg/dL; 95% CI, −4.63 to 12.06; P=.38; I2=80.2%);
    • LDL-C level (WMD, 2.29 mg/dL; 95% CI, −2.45 to 7.03; P=.34);
    • HbA1c level (WMD, −0.03%; 95% CI, −0.45 to 0.39; P=.89; I2=66.2%);
    • systolic blood pressure (WMD, −2.10 mmHg; 95% CI, −4.48 to 0.28; P=.08); and
    • diastolic blood pressure (WMD, 1.04 mmHg; 95% CI, −1.18 to 3.89; P=.48).

Limitations

  • Small sample size.