The Effects of omega-3 Fatty Acids on Diabetic Nephropathy: A Meta-Analysis of Randomized Controlled Trials

PLoS One. 2020 Feb 11;15(2):e0228315. doi: 10.1371/journal.pone.0228315. eCollection 2020.

Abstract

Objective: To evaluate the effects of omega-3 long-chain polyunsaturated fatty acids on proteinuria, estimated glomerular filtration rate (eGFR) and metabolic biomarkers among patients with diabetes.

Study design: Meta-analysis of randomized controlled clinical trials (RCTs).

Setting & subjects: Patients with diabetes.

Selection criteria for studies: We conducted electronic searches in PubMed, Embase and Cochrane Central Register of Controlled Trials from January 1960 to April 2019 to identify RCTs, which examined the effects of omega-3 fatty acids on proteinuria, eGFR and metabolic biomarkers among diabetic patients.

Results: Ten RCTs with 344 participants were included in our meta-analysis. Omega-3 fatty acids reduced the amount of proteinuria among type 2 diabetes mellitus (type 2 DM) and type 1 diabetes mellitus (type 1 DM). This association was only significant among type 2 DM (SMD = -0.29 (95% CI: -0.54, -0.03; p = 0.03). Only studies with duration of intervention of 24 weeks or longer demonstrated a significant lower proteinuria among omega-3 fatty acids compared to control group (SMD = -0.30 (95% CI: -0.58, -0.02; p = 0.04). There was a higher eGFR for both type 1 and type 2 DM groups among omega-3 fatty acids compared to control group, however, the effect was not statistically significant. Regarding serum total cholesterol, LDL-cholesterol and HbA1C, there was no significant difference comparing omega-3 fatty acids to control group. There was a non-significant systolic blood pressure reduction in the omega-3 fatty acids supplementation group compared to control.

Conclusion: Omega-3 fatty acids could help ameliorate proteinuria among type 2 DM who received omega-3 supplementation for at least 24 weeks without adverse effects on HbA1C, total serum cholesterol and LDL-cholesterol.

Publication types

  • Meta-Analysis

MeSH terms

  • Biomarkers / metabolism
  • Cholesterol / blood
  • Cholesterol, LDL / blood
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / pathology*
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / pathology
  • Fatty Acids, Omega-3 / therapeutic use*
  • Glomerular Filtration Rate
  • Glycated Hemoglobin A / analysis
  • Humans
  • Proteinuria / drug therapy*
  • Proteinuria / etiology
  • Randomized Controlled Trials as Topic

Substances

  • Biomarkers
  • Cholesterol, LDL
  • Fatty Acids, Omega-3
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human
  • Cholesterol

Grant support

The authors received no specific funding for this work