Journal
ADVANCES IN NUTRITION
Volume 12, Issue 1, Pages 128-140Publisher
OXFORD UNIV PRESS
DOI: 10.1093/advances/nmaa086
Keywords
DHA; EPA; omega-3; inflammation; C-reactive protein; interleukin; cardiovascular disease; systematic review; meta-analysis
Categories
Funding
- European Marie Sklodowska-Curie Actions
- Canadian Institutes of Health Research (CIHR)
- Fonds de recherche du Quebec-Sante (FRQ-S)
- Canadian Institutes of Health Research through the Canada-wide Human Nutrition Trialists'Network (NTN) [129920]
- Canada Foundation for Innovation (CFI)
- Ministry of Research and Innovation's Ontario Research Fund (ORF)
- PSI Graham Farquharson Knowledge Translation Fellowship
- Diabetes Canada Clinician Scientist Award
- CIHR INMD/CNS New Investigator Partnership Prize
- Banting and Best Diabetes Centre Sun Life Financial New Investigator Award
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Pairwise and network meta-analyses comparing the effects of DHA and EPA on systemic markers of subclinical inflammation suggest that supplementation with either DHA or EPA does not differentially modify these markers.
Recent data from randomized clinical trials (RCTs) suggest that DHA may have stronger anti-inflammatory effects than EPA. This body of evidence has not yet been quantitatively reviewed. The aim of this study was to compare the effect of DHA and EPA on several markers of systemic inflammation by pairwise and network meta-analyses of RCTs. MEDLINE, EMBASE, and The Cochrane Library were searched through to September 2019. We included RCTs of >= 7 d on adults regardless of health status that directly compared the effects of DHA with EPA and RCTs of indirect comparisons, in which the effects of DHA or EPA were compared individually to a control fatty acid. Differences in circulating concentrations of C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha) and adiponectin were the primary outcome measures. Data were pooled by pairwise and network meta-analysis and expressed as mean differences (MDs) with 95% CIs. Heterogeneity was assessed (Cochran Q statistic) and quantified (I-2 statistic) in the pairwise meta-analysis. Inconsistency and transitivity were evaluated in the network meta-analysis. The certainty of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Eligibility criteria were met by 5 RCTs (N = 411) for the pairwise meta-analysis and 20 RCTs (N = 1231) for the network meta-analysis. In the pairwise meta-analysis, DHA and EPA had similar effects on plasma CRP [MDDHA versus EPA = 0.14 mg/L (95% CI: -0.57, 0.85); I-2 = 61%], IL-6 [MDDHA versus EPA = 0.10 pg/mL (-0.15, 0.34); I-2 = 40%], and TNF-alpha [MDDHA versus EPA = -0.10 pg/mL (-0.37, 0.18); I-2 = 40%]. In the network meta-analysis, the effects of DHA and EPA on plasma CRP [MDDHA versus EPA = -0.33 mg/L (-0.75, 0.10)], IL-6 [MDDHA versus EPA = 0.09 pg/mL (-0.12, 0.30)], and TNF-alpha [MDDHA versus EPA = -0.02 pg/mL (-0.25, 0.20)] were also similar. DHA and EPA had similar effects on plasma adiponectin in the network meta-analysis. Results from pairwise and network meta-analyses suggest that supplementation with either DHA or EPA does not differentially modify systemic markers of subclinical inflammation.
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