补充Omega-3脂肪酸在实体器官移植受者：随机对照试验的系统回顾和荟萃分析。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-09-03 DOI:10.1016/j.clnesp.2025.08.035

Sama Samankan , Afshin Gharekhani , Sajad Khiali , Afraa Rezagholizadeh , Amin Agabalazadeha , Parvin Sarbakhsh , Leila Alizadeh , Ali Sharifi , Amin Sadrazar

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引用次数: 0

摘要

背景：众所周知，Omega-3多不饱和脂肪酸具有抗炎和心血管益处，但其对实体器官移植结果的影响尚不清楚。目的：评估补充omega-3对实体器官移植受者临床结果的影响。方法：根据PRISMA指南对随机对照试验进行系统评价和荟萃分析。截至2025年5月，检索了PubMed、Scopus和Web of Science等数据库。符合条件的研究评估了移植相关的结果，主要结果是移植后30天、3个月和1年的移植排斥反应。次要结局包括血脂、血压、肾功能和感染率的变化。结果：纳入16项试验，涉及1020例患者。在移植后30天、3个月或1年，补充Omega-3并没有显著降低排异率。舒张压显著下降（Hedges' g = -0.72; 95% CI: -1.31至-0.13），总胆固醇水平也下降（Hedges' g = -0.64; 95% CI: -1.04至-0.24），尤其是肾移植受者。心脏移植受者收缩压明显下降（Hedges’g = -1.03； 95%可信区间：-1.53 ~ -0.54）。对高、低密度脂蛋白、甘油三酯、肾小球滤过率和肌酐清除率的影响不一致，而且在很大程度上不显著。一项研究报告肾脏受体脓毒症发生率降低（对数优势比= -1.16；95%可信区间：-2.25至-0.07）。钙调磷酸酶抑制剂的毒性未见显著影响。结论：补充Omega-3可能对实体器官移植受者在改善血脂和降低血压方面有好处。然而，研究的异质性和有限的结果数据强调需要更大规模的标准化试验。

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Omega-3 fatty acid supplementation in solid organ transplant recipients: A systematic review and meta-analysis of randomized controlled trials

Background

Omega-3 polyunsaturated fatty acids are known for anti-inflammatory and cardiovascular benefits, but their impact on solid organ transplant outcomes is unclear.

Objectives

To assess the effects of omega-3 supplementation on clinical outcomes in solid organ transplant recipients.

Methods

A systematic review and meta-analysis of randomized controlled trials was conducted according to PRISMA guidelines. Databases including PubMed, Scopus, and Web of Science were searched through May 2025. Eligible studies were evaluated for transplant-related outcomes, with the primary outcome being graft rejection at 30-day, 3-month, and 1-year post-transplant. Secondary outcomes included changes in lipid profile, blood pressure, renal function, and infection rates.

Results

Sixteen trials involving 1,020 patients were included. Omega-3 supplementation did not result in a statistically significant reduction in rejection rates at 30 days, 3 months, or 1 year post-transplant. Diastolic blood pressure decreased significantly (Hedges' g = −0.72; 95 % CI: −1.31 to −0.13), and total cholesterol levels also declined (Hedges' g = −0.64; 95 % CI: −1.04 to −0.24), particularly in kidney transplant recipients. In heart transplant recipients, systolic blood pressure decreased significantly (Hedges’ g = −1.03; 95 % confidence interval: −1.53 to −0.54). Effects on high- and low-density lipoproteins, triglycerides, glomerular filtration rate, and creatinine clearance were inconsistent and largely non-significant. A single study reported reduced sepsis rates in kidney recipients (log odds ratio = −1.16; 95 % confidence interval: −2.25 to −0.07). No significant impact was seen on calcineurin inhibitor toxicity.

Conclusion

Omega-3 supplementation may have benefits for solid organ transplant recipients in terms of improving lipid profiles and reducing blood pressure. However, study heterogeneity and limited outcome data highlight the need for larger, standardized trials.

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.