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PLoS One. 2020 Feb 11;15(2):e0228315. doi: 10.1371/journal.pone.0228315. eCollection 2020.

The effects of omega-3 fatty acids on diabetic nephropathy: A meta-analysis of randomized controlled trials.

Author information

1
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America.
2
Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, United States of America.
3
Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Abstract

OBJECTIVE:

To evaluate the effects of omega-3 long-chain polyunsaturated fatty acids on proteinuria, estimated glomerular filtration rate (eGFR) and metabolic biomarkers among patients with diabetes.

STUDY DESIGN:

Meta-analysis of randomized controlled clinical trials (RCTs).

SETTING & SUBJECTS:

Patients with diabetes.

SELECTION CRITERIA FOR STUDIES:

We conducted electronic searches in PubMed, Embase and Cochrane Central Register of Controlled Trials from January 1960 to April 2019 to identify RCTs, which examined the effects of omega-3 fatty acids on proteinuria, eGFR and metabolic biomarkers among diabetic patients.

RESULTS:

Ten RCTs with 344 participants were included in our meta-analysis. Omega-3 fatty acids reduced the amount of proteinuria among type 2 diabetes mellitus (type 2 DM) and type 1 diabetes mellitus (type 1 DM). This association was only significant among type 2 DM (SMD = -0.29 (95% CI: -0.54, -0.03; p = 0.03). Only studies with duration of intervention of 24 weeks or longer demonstrated a significant lower proteinuria among omega-3 fatty acids compared to control group (SMD = -0.30 (95% CI: -0.58, -0.02; p = 0.04). There was a higher eGFR for both type 1 and type 2 DM groups among omega-3 fatty acids compared to control group, however, the effect was not statistically significant. Regarding serum total cholesterol, LDL-cholesterol and HbA1C, there was no significant difference comparing omega-3 fatty acids to control group. There was a non-significant systolic blood pressure reduction in the omega-3 fatty acids supplementation group compared to control.

CONCLUSION:

Omega-3 fatty acids could help ameliorate proteinuria among type 2 DM who received omega-3 supplementation for at least 24 weeks without adverse effects on HbA1C, total serum cholesterol and LDL-cholesterol.

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