Abstract
Current guidelines recommend that people consume 2 or more servings of fat-rich fish per week to obtain enough omega-3 polyunsaturated fatty acids to prevent cardiovascular events. However, the cardiovascular benefits of omega-3 polyunsaturated fatty acids in patients with diabetes are unclear, and related large-scale trials have produced conflicting results. We aimed to perform a meta-analysis of all randomized controlled trials (RCTs) that attempted to assess the effects of omega-3 fatty acid supplementation on cardiovascular outcomes in patients with diabetes. In PubMed, EMBASE, and the Cochrane Library, we searched for data from all randomized controlled trials on omega-3 fatty acids and cardiovascular outcomes in patients with diabetes published before July 2022. Eight eligible studies involving 57,754 participants were ultimately included. Meta-analysis showed that omega-3 fatty acid supplementation reduces cardiovascular disease (CVD) risk in patients with diabetes (RR=0.93, 95% CI=0.90-0.97, P=0.0009). Among them, eicosapentaenoic acid (EPA), but not EPA plus docosahexaenoic acid (DHA), significantly reduced the risk of CVD in patients with diabetes.[EPA (RR=0.81, 95% CI=0.73-0.90, P=0.0001)]. This meta-analysis suggests that omega-3 fatty acid supplementation is an effective strategy to prevent CVD in patients with diabetes, but further well-designed, large-scale RCTs are necessary to evaluate the safety of omega-3 fatty acid supplementation, and its effect on atrial fibrillation. This study is registered with PROSPERO as CRD42022346302.
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