Effect of Omega-3 Fatty Acids on Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Purpose Omega-3 fatty acid is an emerging hotspot on anti-inflammation and chronic obstructive pulmonary disease (COPD) is known as a chronic inflammatory disease. The effect of Omega-3 fatty acid supplement on patients with COPD remains mixed for insufficient evidence. This systematic review and meta-analysis is based on neat randomized controlled trials trying to give a clearer impression on the effect of Omega-3 on patients with COPD. Methods This systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) statements. Randomized clinical trials (RCTs) published in electronic databases including Medline, Embase, Cochrane Library, ClinicalTrials.gov and China National Knowledge Infrastructure (CNKI) by May 10, 2021 were searched. Data extracted from 6 predetermined domains (nutritional condition, lipid composition, inflammatory biomarker, lung function, physical endurance and quality of life [QoL]) were reviewed and analyzed. Results A total of 8 RCTs evaluating 418 patients (age, mean [SD] = 67.3 [10.2] years) were included. Statistical differences were found in 3 parameters of 3 domains – weight (Wt) (0.25 [95% CI, 0.02 to 0.48], P = 0.03) in nutritional condition, low-density lipoprotein (LDL) (0.70 [95% CI, 0.30 to 1.10], P = 0.00) in lipid composition and interleukin-6 (IL-6) level (−0.32 [95% CI, −0.60 to −0.05], P = 0.02) in inflammatory biomarker – while no significant difference was found in lung function, physical endurance or QoL. Conclusion Comparing with placebo, Omega-3 intake was associated with more weight-gaining, LDL increase and IL-6 reduction. These results should be interpreted cautiously for the quality and quantity of available evidence are limited.

Effects of omega-3 supplementation on quality of life, nutritional status, inflammatory parameters, lipid profile, exercise tolerance and inhaled medications in chronic obstructive pulmonary disease

“…Nutritional status is particularly important because in the chronic progressive course of COPD, malnutrition impairs quality of life, increases the number and risk of exacerbations, length of hospital stay and health care costs, and low BMI is an independent risk factor for mortality (31)(32)(33). Several previous studies have shown that the intake of PUFAs improves the quality of life of patients (15)(16)(17)(18)(19)(34)(35)(36)(37)(38), as COPD is a respiratory and systemic inflammatory disease (36). Omega-3 can slow the inflammatory process and improve quality of life (34)(35)(36)(37)(38).…”

“…Several previous studies have shown that the intake of PUFAs improves the quality of life of patients (15)(16)(17)(18)(19)(34)(35)(36)(37)(38), as COPD is a respiratory and systemic inflammatory disease (36). Omega-3 can slow the inflammatory process and improve quality of life (34)(35)(36)(37)(38).…”

Omega-3 fatty acids: Current insights into mechanisms of action in systemic lupus erythematosus

“…16 In another meta-analysis including eight RCTs and 418 patients, researchers found that omega-3 intake was associated with IL-6 reduction in COPD patients. 137 Omega-3 supplementation's effects on immune responses are debatable at various levels, ranging from 2500 mg/d to higher doses of 4800 mg/d (Table 1). [130][131][132][133][134][135][136]…”

Anti-Inflammatory Function of Fatty Acids and Involvement of Their Metabolites in the Resolution of Inflammation in Chronic Obstructive Pulmonary Disease

“…In this case, adequate dietary intake of ω-3 PUFAs can be considered as a protective factor against the deterioration of lung function in smokers and the progression of COPD. Consumption of ω-3 PUFAs by COPD patients may be associated with weight gain and lower IL-6 levels compared with placebo [ 262 ].…”