Table of Contents
Top line:
Regular intake of fish oil supplements and increasing blood levels of omega-3 polyunsaturated fatty acids (PUFAs), especially docosahexaenoic acid (DHA), have been shown to reduce the risk of vascular complications in patients with type 2 diabetes (T2D).
Methodology:
- Fish oil, rich in omega-3 PUFAs, is a beneficial supplement for vascular health in the general population, but there have been few similar studies in people with type 2 diabetes, despite them being at higher risk of developing vascular disease.
- This prospective cohort study assessed the association between fish oil supplements and risk of vascular complications in 20,338 type 2 diabetes patients (median age 60 years, 39.7% women) with complete supplement use data from UK Biobank and 4,874 type 2 diabetes participants with plasma PUFA data.
- Regular use of fish oil supplements was assessed by electronic questionnaire at baseline from 2006 to 2010, and blood samples were tested for omega-3 fatty acids between June 2019 and April 2020.
- The study outcomes were diabetic macrovascular complications (coronary artery disease, heart failure, peripheral artery disease, and stroke) and microvascular complications (diabetic kidney disease, diabetic retinopathy, and diabetic neuropathy).
- Blood samples taken at recruitment were assessed for biomarkers related to cardiovascular disease.
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- During a mean follow-up of 13.2 years, 5,396 patients developed macrovascular complications and 4,868 developed microvascular complications.
- Use of fish oil supplements was associated with a 10% increased risk of heart disease compared with no use. [adjusted hazard ratio (HR), 0.90; 95% CI, 0.85-0.97] 11% [HR, 0.89; 95% CI, 0.83-0.95] They are associated with a lower risk of composite macrovascular and microvascular complications, respectively, and a lower risk of each individual complication, except for heart failure and stroke.
- Higher plasma concentrations of total n-3 PUFAs, especially DHA, were shown to reduce the risk of multiple macrovascular and microvascular complications in a nonlinear dose-response manner (P Overall < .05; P Associations with idiopathic pulmonary hypertension (nonlinearity < .05) and habitual fish oil supplement use were found.
- The researchers identified seven biomarkers, including lipid profile and inflammation, that together explained 54.4% and 63.1% of the association between plasma levels of DHA and risk of composite macrovascular complications and coronary heart disease, respectively.
Exercise:
“In patients with type 2 diabetes, habitual fish oil intake and increased plasma omega-3 PUFA concentrations, especially DHA, were associated with a reduced risk of macro- and microvascular complications. Moreover, the favorable association between plasma DHA and diabetic complications was partly mediated by improved lipid profile and biomarkers of inflammation,” the authors write.
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The research was led by Shufan Tian and Tianyu Guo of the Department of Nutrition and Food Hygiene, Hubei Provincial Key Laboratory of Food and Nutrition Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Publish online in Journal of Clinical Endocrinology and Metabolism.
Limitations:
As this was an observational study, causal relationships could not be established. Detailed information on the dosage, composition, and duration of fish oil use was lacking. The study was limited to total omega-3 PUFA and DHA only.
Disclosure:
This study was supported by the National Natural Science Foundation of China, the Hubei Provincial Outstanding Young Researchers Scientific Fund, and the Fundamental Research Funds for the Central Universities. The authors declared that they have no conflicts of interest.
