Effects of n-3 polyunsaturated fatty acid on metabolic status in women with polycystic ovary syndrome: a meta-analysis of randomized controlled trials.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 36932420 · doi:10.1186/s13048-023-01130-4
What was done
A systematic review and meta-analysis (CRD42021285233) evaluated the effects of n-3 polyunsaturated fatty acids (n-3 PUFA) on metabolic parameters in women with polycystic ovary syndrome (PCOS). Four databases (PubMed, Cochrane Library, Embase, Web of Science) were searched through October 2021. Quality was assessed using the Cochrane Risk of Bias Tool. Mean differences (MD) and 95% confidence intervals (CIs) were pooled across continuous outcomes. Subgroup analyses examined study duration (≤8 vs. >8 weeks), source (marine vs. plant), and dosage (≤1000 vs. >1000 mg/day). A total of 11 RCTs with 816 patients were included.
What was found
Compared with controls, n-3 PUFA supplementation significantly reduced waist circumference (MD = -2.76, 95% CI: -3.82 to -1.69, p < 0.00001), fasting plasma glucose (MD = -3.91, 95% CI: -5.69 to -2.13, p < 0.0001), fasting insulin (MD = -2.45, 95% CI: -3.19 to -1.71, p < 0.00001), HOMA-IR (MD = -0.45, 95% CI: -0.80 to -0.11, p = 0.01), triglycerides (MD = -9.33, 95% CI: -10.56 to -8.10, p < 0.00001), total cholesterol (MD = -12.32, 95% CI: -19.15 to -5.50, p = 0.0004), and LDL-C (MD = -10.53, 95% CI: -19.31 to -1.75, p = 0.02). It significantly increased QUICKI (MD = 0.01, 95% CI: 0.01 to 0.02, p < 0.00001) and adiponectin (MD = 1.46, 95% CI: 1.12 to 1.80, p < 0.00001). No significant changes occurred in body weight, BMI, HDL-C, VLDL-C, or hs-CRP. Subgroup analysis showed durations >8 weeks were more effective for improving insulin resistance and lipid profiles.
Why it matters
This review provides quantitative evidence that n-3 PUFA supplementation can improve markers of insulin sensitivity and dyslipidemia in PCOS, supporting its use as an adjunctive metabolic therapy when given for more than 8 weeks.
Limits
The total sample size was modest (816 participants across 11 studies). The abstract does not report measurement units, statistical heterogeneity (I² values), risk of bias ratings, adverse events, or long-term clinical endpoints such as ovulatory function or cardiovascular events.
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