Treatment with n-3 polyunsaturated fatty acids overcomes the inverse association of vitamin D deficiency with inflammation in severely obese patients: a randomized controlled trial

PLoS One. 2013;8(1):e54634. doi: 10.1371/journal.pone.0054634. Epub 2013 Jan 25.

Abstract

Obesity affects the vitamin D status in humans. Vitamin D and long-chain n-3 polyunsaturated fatty acids (PUFA) provide benefit for the prevention of fractures and cardiovascular events, respectively, and both are involved in controlling inflammatory and immune responses. However, published epidemiological data suggest a potential interference of n-3 PUFA supplementation with vitamin D status. Therefore, we aimed to investigate in a randomized controlled clinical trial whether treatment with long chain n-3 PUFA affects vitamin D status in severely obese patients and potential interrelations of vitamin D and PUFA treatment with inflammatory parameters. Fifty-four severely obese (BMI ≥ 40 kg/m2) non-diabetic patients were treated for eight weeks with either 3.36 g/d EPA and DHA or the same amount of butter fat as control. Changes in serum 25-hydroxy-vitamin D [25(OH)D] concentrations, plasma fatty acid profiles and circulating inflammatory marker concentrations from baseline to end of treatment were assessed. At baseline 43/54 patients were vitamin D deficient (serum 25(OH)D concentration <50 nmol/l). Treatment with n-3 PUFA did not affect vitamin D status (P = 0.91). Serum 25(OH)D concentration correlated negatively with both IL-6 (P = 0.02) and hsCRP serum concentration (P = 0.03) at baseline. Strikingly, the negative correlations of 25(OH)D with IL-6 and hsCRP were lost after n-3 PUFA treatment. In conclusion, vitamin D status of severely obese patients remained unaffected by n-3 PUFA treatment. However, abrogation of the inverse association of 25(OH)D concentration with inflammatory markers indicated that n-3 PUFA treatment could compensate for some detrimental consequences of vitamin D deficiency.

Trial registration: ClinicalTrials.gov NCT00760760.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Eicosapentaenoic Acid / blood
  • Fatty Acids, Omega-3 / therapeutic use*
  • Female
  • Humans
  • Inflammation / blood
  • Inflammation / complications*
  • Inflammation / drug therapy*
  • Interleukin-6 / blood
  • Male
  • Middle Aged
  • Obesity / blood
  • Obesity / complications*
  • Treatment Outcome
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / complications*
  • Vitamin D Deficiency / drug therapy*

Substances

  • Fatty Acids, Omega-3
  • Interleukin-6
  • Vitamin D
  • 25-hydroxyvitamin D
  • Eicosapentaenoic Acid

Associated data

  • ClinicalTrials.gov/NCT00760760

Grants and funding

This work was supported by the Austrian National Bank Project no. 12735; the European Community's 7th Framework Programme (FP7/2007-2013) under grant agreement no. 201608; the Federal Ministry of Economy, Family and Youth; and the National Foundation for Research, Technology and Development (all to TMS). Omacor® capsules were generously provided by Solvay Pharma, Austria. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.