Fish oil supplementation decreases serum soluble receptor activator of nuclear factor-kappa B ligand/osteoprotegerin ratio in female patients with rheumatoid arthritis

Kolahi, Sousan; Ghorbanihaghjo, Amir; Alizadeh, Samira; Rashtchizadeh, Nadereh; Argani, Hassan; Khabazzi, Ali-Reza; Hajialilo, Mehrzad; Bahreini, Elham

doi:10.1016/j.clinbiochem.2009.12.011

Cited by 40 publications

(23 citation statements)

References 46 publications

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“…Five studies (41 – 45) showed no significant difference in effect size of treatment versus control, and one study (46) did not provide sufficient data for effect size calculation. A moderate quality of evidence level was given to three of the four significant RCTs (See Table 2).…”

Section: Resultsmentioning

confidence: 99%

A systematic review of omega-3 fatty acids and osteoporosis

et al. 2012

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Some epidemiological evidence suggests that diets high in omega 3 fatty acids (n-3 FAs) may be beneficial for skeletal health. The aim of this systematic review was to determine if randomized controlled trials (RCTs) support a positive effect of n-3 FAs on osteoporosis. A systematic search was performed in PubMed and EMBASE databases. We included RCTs with skeletal outcomes conducted in adults or children (.¼ 1 year old) using n-3 FA fortified foods, diets or supplements alone or in combination with other vitamins/minerals, versus placebo. Primary outcomes were incident fracture at any site and bone mineral density (BMD) in g/cm 2 . Secondary outcomes included bone formation or resorption markers and bone turnover regulators. A total of 10 RCTs met inclusion criteria. Effect sizes with 95 % confidence intervals were estimated to compare studies across various treatments and outcome measures. No pooled analysis was completed due to heterogeneity of studies and small sample sizes. No RCTs included fracture as an outcome. Four studies reported significant favorable effects of n-3 FA on BMD or bone turnover markers. Of these, three delivered n-3 FA in combination with high calcium foods or supplements. Five studies reported no differences in outcomes between n-3 FA intervention and control groups; one study included insufficient data for effect size estimation. Strong conclusions regarding n-3 FAs and bone disease are limited due to the small number and modest sample sizes of RCTs, however, it appears that any potential benefit of n-3 FA on skeletal health may be enhanced by concurrent administration of calcium.

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Section: Resultsmentioning

confidence: 99%

A systematic review of omega-3 fatty acids and osteoporosis

et al. 2012

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“…48 studies including 61 independent comparisons involved patients with chronic non-autoimmune disease as subjects [19]–[21], [35]–[39], [42]–[44], [46]–[48], [50], [52], [53], [56], [58]–[63], [65], [67], [68], [70]–[78], [80], [83], [84], [86], [88], [89], [92], [94]–[98], 2 studies including 2 independent comparisons involved patients with chronic auto-immune disease as subjects [57], [93], and 17 studies including 22 independent comparisons involved healthy people as subjects [22], [40], [41], [49], [51], [54], [55], [64], [66], [69], [79], [81], [82], [85], [87], [90], [91]. In addition, one study including one independent comparison recruited both subjects with chronic non-autoimmune disease and subjects with chronic autoimmune disease [45].…”

Section: Resultsmentioning

confidence: 99%

“…Only one study assessed the effect of marine-derived n-3 PUFAs supplementation on TNF-α [57], and a marginally significant lowering effect was observed (WMD, −0.28; 95% CI, −0.57 to 0.01; P = 0.061); the percentage of change (in geometric mean) was −24.42% (95% CI, −43.45% to 1.01%). No studies assessed the effect of marine-derived n-3 PUFAs supplementation on IL-6.…”

Section: Resultsmentioning

confidence: 99%

Effect of Marine-Derived n-3 Polyunsaturated Fatty Acids on C-Reactive Protein, Interleukin 6 and Tumor Necrosis Factor α: A Meta-Analysis

et al. 2014

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BackgroundPrevious studies did not draw a consistent conclusion about the effects of marine-derived n-3 polyunsaturated fatty acids (PUFAs) on fasting blood level of C-reactive protein (CRP), interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α).Methods and FindingsA comprehensive search of Web of Science, PubMed, Embase and Medline (from 1950 to 2013) and bibliographies of relevant articles was undertaken. Sixty-eight RCTs with a total of 4601 subjects were included in the meta-analysis. Marine-derived n-3 PUFAs supplementation showed a lowering effect on Marine-derived n-3 PUFAs supplementation had a significant lowering effect on TNF-α, IL-6 and CRP in three groups of subjects (subjects with chronic non-autoimmune disease, subjects with chronic autoimmune disease and healthy subjects). A significant negative linear relationship between duration and effect size of marine-derived n-3 PUFAs supplementation on fasting blood levels of TNF-α and IL-6 in subjects with chronic non-autoimmune disease was observed, indicating that longer duration of supplementation could lead to a greater lowering effect. A similar linear relationship was also observed for IL-6 levels in healthy subjects. Restricted cubic spline analysis and subgroup analysis showed that the lowering effect of marine-derived n-3 PUFAs on CRP, IL-6 and TNF-α in subjects with chronic non-autoimmune disease became weakened when body mass index was greater than 30 kg/m2. The effect of marine-derived n-3 PUFAs from dietary intake was only assessed in subjects with chronic non-autoimmune disease, and a significant lowering effect was observed on IL-6, but not on CRP and TNF-α.ConclusionsMarine-derived n-3 PUFAs supplementation had a significant lowering effect on CRP, IL-6 and TNF-α level. The lowering effect was most effective in non-obese subjects and consecutive long-term supplementation was recommended.

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“…Although the exact mechanism of action of these supplements in suppressing osteoclastogenesis still requires further investigation, rodent and human studies in estrogen deficiency or non-challenged settings have also shown the ability of n-3 PUFAs and genistein to suppress IL-6, IL-1 and TNF-α expression and/or to lower RANKL/OPG ratio, thus attenuating osteoclast formation and activity [29], [32], [40], [54], [68], [69], [70], [71]. Similarly, a clinical study has shown that fish oil supplementation in rheumatoid arthritis patients was associated with decreased production of IL-1 and TNF-α [72]. Therefore, fish oil and genistein in the current study were shown to suppress MTX treatment-induced expression of the pro-inflammatory cytokines and RANKL/OPG ratio, which may have contributed to reduced osteoclast differentiation and reduced bone resorption in the supplemented rats.…”

Section: Discussionmentioning

confidence: 99%

Supplementation with Fish Oil and Genistein, Individually or in Combination, Protects Bone against the Adverse Effects of Methotrexate Chemotherapy in Rats

et al. 2013

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Cancer chemotherapy has been shown to induce long-term skeletal side effects such as osteoporosis and fractures; however, there are no preventative treatments. This study investigated the damaging effects of anti-metabolite methotrexate (MTX) subcutaneous injections (0.75 mg/kg BW) for five days and the potential protective benefits of daily oral gavage of fish oil at 0.5 mL/100 g BW (containing 375 mg of n-3 PUFA/100 g BW), genistein (2 mg/100 g BW), or their combination in young adult rats. MTX treatment alone significantly reduced primary spongiosa height and secondary spongiosa trabecular bone volume. Bone marrow stromal cells from the treated rats showed a significant reduction in osteogenic differentiation but an increase in adipogenesis ex vivo. Consistently, stromal cells had significantly higher mRNA levels of adipogenesis-related proliferator activator activated receptor-γ (PPAR-γ) and fatty acid binding protein (FABP4). MTX significantly increased the numbers of bone-resorbing osteoclasts and marrow osteoclast precursor cell pool while significantly enhancing the mRNA expression of receptor activator for nuclear factor kappa B ligand (RANKL), the RANKL/osteoprotegerin (OPG) ratio, interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in the bone. Supplementary treatment with fish oil and/or genistein significantly preserved trabecular bone volume and osteogenesis but suppressed MTX-induced adipogenesis and increases in osteoclast numbers and pro-osteoclastogenic cytokine expression. Thus, Fish oil and/or genistein supplementation during MTX treatment enabled not only preservation of osteogenic differentiation, osteoblast number and bone volume, but also prevention of MTX treatment-induced increases in bone marrow adiposity, osteoclastogenic cytokine expression and osteoclast formation, and thus bone loss.

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Fish oil supplementation decreases serum soluble receptor activator of nuclear factor-kappa B ligand/osteoprotegerin ratio in female patients with rheumatoid arthritis

Cited by 40 publications

References 46 publications

A systematic review of omega-3 fatty acids and osteoporosis

A systematic review of omega-3 fatty acids and osteoporosis

Effect of Marine-Derived n-3 Polyunsaturated Fatty Acids on C-Reactive Protein, Interleukin 6 and Tumor Necrosis Factor α: A Meta-Analysis

Supplementation with Fish Oil and Genistein, Individually or in Combination, Protects Bone against the Adverse Effects of Methotrexate Chemotherapy in Rats

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