目的:长链omega-3(LCn3)和omega-6脂肪酸对炎症性肠病的预防和治疗(IBD,包括克罗恩病,CD和溃疡性结肠炎,UC),炎症还不清楚。我们系统地回顾了omega-3,omega-6和总多不饱和脂肪(PUFA)对IBD诊断的长期影响,复发,严重程度,药物治疗,生活质量和关键炎症标志物。
方法:我们搜索了Medline,Embase,科克伦中部,和审判登记处,包括患有或不患有IBD的成年人的RCTs,比较高和低的omega-3,omega-6和/或PUFA总摄入量≥24周,评估IBD特异性结局或炎症生物标志物。
结果:我们包括83个RCT(41,751名参与者),其中招募了13名IBD参与者。LCn3升高可降低IBD复发(RR0.85,95%CI0.72-1.01)和IBD恶化(RR0.85,95%CI0.71-1.03)的风险,并降低红细胞沉降率(ESR,SMD-0.23,95%CI-0.44至-0.01),但可能会增加IBD诊断风险(RR1.10,95%CI0.63-1.92),和粪便钙卫蛋白,IBD的特定炎症标志物(MD16.1μg/g,95%CI-37.6至69.8,所有低质量证据)。α-亚麻酸的结果,omega-6和总PUFA稀疏,但建议在数据可用的地方效果很小或没有效果。
结论:这是对研究omega-3、omega-6和总PUFA对IBD和炎症标志物的长期影响的随机对照试验的最全面的荟萃分析。我们的发现表明,补充PUFA对IBD的预防或治疗影响很小或没有影响,并且对长期炎症状态的改变几乎没有支持。
OBJECTIVE: Effects of long-chain omega-3 (LCn3) and omega-6 fatty acids on prevention and treatment of inflammatory bowel diseases (IBD, including Crohn\'s Disease, CD and ulcerative colitis, UC), and inflammation are unclear. We systematically reviewed long-term effects of omega-3, omega-6 and total polyunsaturated fats (PUFA) on IBD diagnosis, relapse, severity, pharmacotherapy, quality of life and key inflammatory markers.
METHODS: We searched Medline, Embase, Cochrane CENTRAL, and trials registries, including RCTs in adults with or without IBD comparing higher with lower omega-3, omega-6 and/or total PUFA intake for ≥ 24 weeks that assessed IBD-specific outcomes or inflammatory biomarkers.
RESULTS: We included 83 RCTs (41,751 participants), of which 13 recruited participants with IBD. Increasing LCn3 may reduce risk of IBD relapse (RR 0.85, 95% CI 0.72-1.01) and IBD worsening (RR 0.85, 95% CI 0.71-1.03), and reduce erythrocyte sedimentation rate (ESR, SMD - 0.23, 95% CI - 0.44 to - 0.01), but may increase IBD diagnosis risk (RR 1.10, 95% CI 0.63-1.92), and faecal calprotectin, a specific inflammatory marker for IBD (MD 16.1 μg/g, 95% CI - 37.6 to 69.8, all low-quality evidence). Outcomes for alpha-linolenic acid, omega-6 and total PUFA were sparse, but suggested little or no effect where data were available.
CONCLUSIONS: This is the most comprehensive meta-analysis of RCTs investigating long-term effects of omega-3, omega-6 and total PUFA on IBD and inflammatory markers. Our findings suggest that supplementation with PUFAs has little or no effect on prevention or treatment of IBD and provides little support for modification of long-term inflammatory status.