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Cited by 126Fatty Acid Research and HealthNutritional Studies and DietAquaculture Nutrition and Growth

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Marine N-3 Polyunsaturated Fatty Acids Are Inversely Associated with Risk of Type 2 Diabetes in Asians: A Systematic Review and Meta-Analysis

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Zheng, Ju-Sheng, Huang, Tao, Yang, Jing, Fu, Yuan-Qing, Li, Duo·2012·PLoS ONE
DOI 10.1371/journal.pone.0044525PMC PMC3439396
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Abstract

BACKGROUND: Prospective cohort studies in relation to the associations between n-3 polyunsaturated fatty acids (PUFA) and risk of type 2 diabetes (T2D) were inconsistent. Differences in tissue n-3 PUFA compositions in subjects with and without T2D were also inconsistent in both cohort and case-control studies. We conducted a systematic review and meta-analysis of prospective cohort studies to examine the associations of fish and n-3 PUFA intake with T2D risk. The differences in tissue n-3 PUFA compositions in subjects with and without T2D were investigated based on cohort and case-control studies. METHODS AND FINDINGS: PubMed, Embase, Cochrane library, China National Knowledge Infrastructure (CNKI) and Chinese VIP database up to January 2012 was used to identify relevant studies, and reference lists from retrieved studies were reviewed. Two authors independently extracted the data. Random-effects models were used to pool the summary relative risk (RR). Twenty-four studies including 24,509 T2D patients and 545,275 participants were identified. For cohort studies, the summary RR of T2D for the highest vs lowest categories of total fish, marine n-3 PUFA and alpha-linolenic acid intake was 1.07 (95% CI: 0.91, 1.25), 1.07 (95% CI: 0.95, 1.20) and 0.93 (95% CI: 0.81, 1.07), respectively. Subgroup analyses indicated that summary RR (highest vs lowest category) of T2D for fish and marine n-3 PUFA intake was 0.89 (95% CI: 0.81, 0.98) and 0.87 (95% CI: 0.79, 0.96) for Asian populations, and 1.20 (95% CI: 1.01, 1.44) and 1.16 (95% CI: 1.04, 1.28) for Western populations. Asian subjects with T2D had significantly lower tissue compositions of C22:6n-3 (SMD: -1.43; 95% CI: -1.75, -1.12) and total n-3 PUFA (SMD: -1.41; 95% CI: -2.23, -0.59) compared with those without T2D. CONCLUSION: This systematic review and meta-analysis provides evidence that marine n-3 PUFA have beneficial effects on the prevention of T2D in Asian populations.

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Figure 1 PRISMA flow diagram for selection of studies in the meta-analysis.
Figure 1 PRISMA flow diagram for selection of studies in the meta-analysis.CC BY · PubMed Central
Figure 2 Relative risk of type 2 diabetes for highest vs lowest categories of total fish intake. The combined relative risk was achieved using random-effects model. Grey square represents relative risk in each study, with square size reflecting the study-specific weight and the 95% CI represented by horizontal bars. The diamond indicates summary risk estimate.
Figure 2 Relative risk of type 2 diabetes for highest vs lowest categories of total fish intake. The combined relative risk was achieved using random-effects model. Grey square represents relative risk in each study, with square size reflecting the study-specific weight and the 95% CI represented by horizontal bars. The diamond indicates summary risk estimate.CC BY · PubMed Central
Figure 3 Relative risk of type 2 diabetes for highest vs lowest categories of marine n-3 polyunsaturated fatty acids intake. The combined relative risk was achieved using random-effects model. Grey square represents relative risk in each study, with square size reflecting the study-specific weight and the 95% CI represented by horizontal bars. The diamond indicates summary risk estimate.
Figure 3 Relative risk of type 2 diabetes for highest vs lowest categories of marine n-3 polyunsaturated fatty acids intake. The combined relative risk was achieved using random-effects model. Grey square represents relative risk in each study, with square size reflecting the study-specific weight and the 95% CI represented by horizontal bars. The diamond indicates summary risk estimate.CC BY · PubMed Central
Figure 4 Relative risk of type 2 diabetes for highest vs lowest categories of alpha-linolenic acid intake. The combined relative risk was achieved using random-effects model. Grey square represents relative risk in each study, with square size reflecting the study-specific weight and the 95% CI represented by horizontal bars. The diamond indicates summary risk estimate.
Figure 4 Relative risk of type 2 diabetes for highest vs lowest categories of alpha-linolenic acid intake. The combined relative risk was achieved using random-effects model. Grey square represents relative risk in each study, with square size reflecting the study-specific weight and the 95% CI represented by horizontal bars. The diamond indicates summary risk estimate.CC BY · PubMed Central
Figure 5 Effect of type 2 diabetes on tissue C22∶6n-3 composition compared with controls. The combined standardized mean difference (SMD) was achieved using random-effects model. Grey square represents SMD in each study, with square size reflecting the study-specific weight and the 95% CI represented by horizontal bars. The diamond indicates summary SMD.
Figure 5 Effect of type 2 diabetes on tissue C22∶6n-3 composition compared with controls. The combined standardized mean difference (SMD) was achieved using random-effects model. Grey square represents SMD in each study, with square size reflecting the study-specific weight and the 95% CI represented by horizontal bars. The diamond indicates summary SMD.CC BY · PubMed Central
Figure 6 Effect of type 2 diabetes on tissue total n-3 PUFA composition compared with controls. The combined standardized mean difference (SMD) was achieved using random-effects model. Grey square represents SMD in each study, with square size reflecting the study-specific weight and the 95% CI represented by horizontal bars. The diamond indicates summary SMD.
Figure 6 Effect of type 2 diabetes on tissue total n-3 PUFA composition compared with controls. The combined standardized mean difference (SMD) was achieved using random-effects model. Grey square represents SMD in each study, with square size reflecting the study-specific weight and the 95% CI represented by horizontal bars. The diamond indicates summary SMD.CC BY · PubMed Central

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  1. [32]Zhang B, Wang ZZ, Song HP (2011) The change of plasma long-chain polyunsaturated fatty acids in type 2 diabetes (in Chinese). Journal of China Traditional Chinese Medicine Information 3: 353– 354.

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Metadata

Authors
Zheng, J.-S., Huang, T., Yang, J., Fu, Y.-Q., & Li, D.
Affiliations
Zhejiang University (CN)
Corresponding author
Li, Duo
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2012-09-11
Volume
7
Issue
9
Pages
e44525
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0044525
PMC
PMC3439396
OpenAlex
W2074950966
Cited by
126
References
57
Citations by year
2025: 6 · 2024: 8 · 2023: 5 · 2022: 6 · 2021: 8 · 2020: 8 · 2019: 8 · 2018: 17 · 2017: 6 · 2016: 19 · 2015: 11 · 2014: 12 · 2013: 12
FWCI
1.37
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
Funders
  • National Natural Science Foundation of China (973 Program, 2011CB504002, 30972464)
  • National Key Research and Development Program of China (30972464, 2011CB504002)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Life Sciences › Agricultural and Biological Sciences › Aquatic Science › Aquaculture Nutrition and Growth
Keywords
type 2 diabetes, omega-3 fatty acids, marine fatty acids, fish consumption, alpha-linolenic acid, dietary intake, tissue fatty acid composition, Asian populations, Western populations, docosahexaenoic acid, EPA, diabetes risk, prospective cohort, subgroup analysis by ethnicity, omega-3 supplementation, diabetes remission, glycemic control
MeSH terms
Adult, Aged, Animals, Diabetes Mellitus, Type 2, Diet, Female, Fish Oils, Humans, Male, Middle Aged, Prospective Studies, Risk, Cohort Studies, Fatty Acids, Omega-3, Case-Control Studies, Asian People

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