Effects of omega-3 supplementation on endothelial function, vascular structure, and metabolic parameters in adolescents with type 1 diabetes mellitus: A randomized clinical trial

Abstract

BackgroundVascular dysfunction is a major complication of diabetes mellitus that leads to cardiovascular disease (CVD). This study aimed to examine the effects of omega-3 consumption on endothelial function, vascular structure, and metabolic parameters in adolescents with type 1 diabetes mellitus (T1DM).MethodsIn this randomized, double-blind, placebo-controlled clinical trial, 51 adolescents (10–18 years) with T1DM completed the study. Patients received 600 mg/day [containing 180 mg eicosapentaenoic acid (EPA) and 120 mg docosahexaenoic acid (DHA)] of omega-3 or placebo for 12 weeks. Flow-mediated dilation (FMD), carotid intima-media thickness (CIMT), high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol, blood urea nitrogen (BUN), creatinine, fasting blood sugar (FBS), hemoglobin A1C (HbA1c), homeostatic model assessment for insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), serum insulin (SI), urine albumin-creatinine ratio (uACR), blood pressure, and anthropometric indices were assessed at the baseline and after the intervention.ResultsFollowing supplementation, omega-3 significantly increased FMD (3.1 ± 4.2 vs. −0.6 ± 4%, p = 0.006) and decreased TG (−7.4 ± 10.7 vs. −0.1 ± 13.1 mg/dl, p = 0.022) in comparison with the placebo group. However, no significant difference was observed regarding CIMT (-0.005 ± 0.036 vs. 0.003 ± 0.021 mm, p = 0.33). Although hs-CRP was significantly decreased within the omega-3 group (p = 0.031); however, no significant change was observed compared to placebo group (p = 0.221). Omega-3 supplementation had no significant effect on other variables.ConclusionGiven the elevation in FMD and reduction in TG, omega-3 supplementation can improve vascular function and may reduce the risk of cardiovascular disease in adolescents with T1DM patients.

Eicosapentaenoic and Docosahexaenoic Acid Supplementation Increases HDL Content in n-3 Fatty Acids and Improves Endothelial Function in Hypertriglyceridemic Patients

“…Moreover, we focused on individuals who did not take any medication and with glucose levels below 125 mg/dL. Consequently, our data support the idea that n3 supplementation is useful for improving FMD in patients with a vascular function relatively preserved, as observed in this and other studies [ 20 , 23 ]. Conversely, when advanced atherosclerotic disease is already established, EPA and DHA do not seem to report a benefit on vascular function [ 21 ].…”

Omega‐3 fatty acids and endothelial function: A GRADE‐assessed systematic review and meta‐analysis

“…The sample size of included 1 presents the main characteristics and baseline parameters of the included trials. These RCTs were performed in Korea, 18,19 UK, [20][21][22][23] Iran, 24 USA, [25][26][27][28][29][30] Greece, [31][32][33] Norway, 34 Poland, [35][36][37][38] Turkey, 39 Italy, 40,41 China, 42 German, 43,44 Denmark, 45 Australia 46 and Austria 47 between 2003 and 2022. Nine studies were crossover and others had a parallel design.…”

“…Based on Cochrane Cooperation's tool 10 studies were good, 22,24,27,28,34,35,42,44,47,48 16 studies were fair 20,21,23,26,[30][31][32][33]35,37,41,45,46,[49][50][51][52] and other studies poor quality. 19,25,36,38,47,53 All studies had a low source of bias in random sequence generation and selective reporting.…”

Endothelial Dysfunction in Diabetes Mellitus: New Insights

“…Khorshidi et al published a randomized, double-blind, placebo-controlled trial with 51 adolescents with T1DM who received either 600 mg per day of omega-3 fatty acids (containing 180 mg of EPA and 120 mg of DHA) or placebos for 12 weeks [ 60 ]. At baseline and after the intervention, the subjects were assessed via ultrasound and using biochemical parameters, including FMD, cIMT, high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rates, triglycerides, LDL, high-density lipoproteins (HDLs), total cholesterol, blood urea nitrogen, creatinine, fasting blood glucose, HbA1c, and the HOMA-IR index.…”