Sex Differences in Omega-3 and Omega-6 PUFA Status: A Systematic Review and Meta-analysis of Cross-Sectional Comparisons

IF 12.7 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition Pub Date : 2026-07-01 Epub Date: 2026-06-09 DOI:10.1016/j.advnut.2026.100670

Dandan Li, Cherie Shum, Ariel Khoo, Tanya Shi, Miranda R Green, Sonia Blanco Mejia, Tauseef A Khan, Laura Chiavaroli, John L Sievenpiper, Adam H Metherel

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引用次数: 0

Abstract

Sex hormones may regulate the biosynthesis of PUFAs; however, the extent and consistency of sex differences in different lipid pools remain unclear. We aimed to update and synthesize evidence on sex differences in circulating and tissue omega (ω)-3 (n–3) and ω-6 (n–6) PUFA biomarkers in healthy adults with a mean age ≤50 y. We systematically searched Medline, Embase, and Cochrane Central Register of Controlled Trials through to 21 February, 2026, for cross-sectional reports of n–3 and n–6 PUFA levels for both sexes in plasma total lipids, phospholipids, triglycerides, and cholesteryl esters (CE); erythrocyte total lipids, phosphatidylcholine, and phosphatidylethanolamine; or adipose tissue. Unadjusted mean differences (MD) between male and female n–3 and n–6 PUFA levels were pooled using random-effects meta-analysis. We identified 67 eligible publications, including 85 comparisons from observational studies and clinical trials, yielding a synthesis of 71 PUFA biomarkers. By absolute difference in percentage of total fatty acids, we observed, in males compared with females, higher n–3 docosapentaenoic acid (DPAn–3) [MD = 0.19%, 95% confidence interval (CI): 0.10%, 0.27%, P < 0.0001, I² = 74%] and lower DHA (MD = −0.32%, 95% CI: –0.46%, –0.18%, P < 0.00001, I² = 59%) in total erythrocytes and in total plasma. Males had lower plasma linoleic acid and higher CE γ-linolenic acid and dihomo-γ-linolenic acid. Heterogeneity in total erythrocyte EPA and DHA was explained by study location, with sex differences in erythrocyte DHA driven by studies in North America and Europe. The certainty of the evidence for all outcomes was graded as low or very low. Future studies should consider sex as a modifier of n–3 and n–6 PUFA status in adult males and females of childbearing age. Higher DPAn–3 and lower DHA in males point to important biological differences in this portion of the n–3 PUFA biosynthesis pathway that require further investigation.

This trial was registered at PROSPERO as CRD42023452859.

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omega-3和omega-6多不饱和脂肪酸状态的性别差异：横断面比较的系统回顾和荟萃分析。

性激素可能调节多不饱和脂肪酸（PUFAs）的生物合成，然而，不同脂质池中性别差异的程度和一致性尚不清楚。我们旨在更新和综合平均年龄≤50岁的健康成人循环和组织中omega-3 （n-3）和omega-6 (n-6) PUFA生物标志物的性别差异的证据。我们系统地检索了Medline、Embase和Cochrane中央对照试验注册库，检索了截至2026年2月21日两性血浆总脂、磷脂、甘油三酯、胆固醇酯（CE）中n-3和n-6 PUFA水平的横断报告；红细胞总脂、磷脂酰胆碱、磷脂酰乙醇胺；或者脂肪组织。采用随机效应荟萃分析，对男性和女性n-3和n-6 PUFA水平的未调整平均差异（MD）进行汇总。我们确定了67篇符合条件的出版物，包括85篇来自观察性研究和临床试验的比较，合成了71种PUFA生物标志物。通过总脂肪酸百分比的绝对差异，我们观察到，在男性和女性中，总红细胞和总血浆中n-3二十二碳五烯酸（DPAn-3）（MD=0.19%, 95% CI: 0.10, 0.27, P2=74%）较高，二十二碳六烯酸（DHA）（MD=-0.32%, 95% CI: -0.46, -0.18, P2=59%）较低。男性有较低的血浆LA和较高的CE -亚麻酸和二homo -亚麻酸。红细胞总EPA和DHA的异质性可以用研究地点来解释，北美和欧洲的研究推动了红细胞DHA的性别差异。所有结果的证据的确定性被评为低或非常低。未来的研究应考虑性别作为育龄成年男性和女性n-3和n-6 PUFA状态的修饰因素。男性较高的DPAn-3和较低的DHA表明n-3 PUFA生物合成途径的这一部分存在重要的生物学差异，需要进一步研究。意义声明：这项系统回顾和荟萃分析更新了育龄成人中omega-3和omega-6 PUFA生物标志物的性别差异证据，表明血浆和红细胞总脂质中男性的DPAn-3水平高于女性，DHA水平低于女性。第一次，研究地点解释了红细胞DHA的异质性，北美和欧洲的研究推动了性别差异。

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来源期刊

Advances in Nutrition 医学-营养学

CiteScore

17.40

自引率

2.20%

发文量

117

审稿时长

56 days

期刊介绍： Advances in Nutrition (AN/Adv Nutr) publishes focused reviews on pivotal findings and recent research across all domains relevant to nutritional scientists and biomedical researchers. This encompasses nutrition-related research spanning biochemical, molecular, and genetic studies using experimental animal models, domestic animals, and human subjects. The journal also emphasizes clinical nutrition, epidemiology and public health, and nutrition education. Review articles concentrate on recent progress rather than broad historical developments. In addition to review articles, AN includes Perspectives, Letters to the Editor, and supplements. Supplement proposals require pre-approval by the editor before submission. The journal features reports and position papers from the American Society for Nutrition, summaries of major government and foundation reports, and Nutrient Information briefs providing crucial details about dietary requirements, food sources, deficiencies, and other essential nutrient information. All submissions with scientific content undergo peer review by the Editors or their designees prior to acceptance for publication.