omega-3脂肪酸摄入与糖尿病视网膜病变风险之间的关系：一项系统综述和荟萃分析

IF 4 3区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Nutrition Health & Aging Pub Date : 2025-09-22 DOI:10.1016/j.jnha.2025.100632

Kai-Yang Chen , Hoi-Chun Chan , Chi-Ming Chan

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引用次数: 0

摘要

背景：糖尿病视网膜病变是糖尿病的一种重要的微血管并发症，其特征是视网膜血管的进行性损害。目前的管理战略侧重于改变危险因素和治疗既定疾病。Omega-3多不饱和脂肪酸（PUFAs）具有抗炎、抗氧化和血管保护特性。目的评价omega-3脂肪酸对不同糖尿病人群DR发病、进展和微血管健康的保护作用。方法通过PubMed、EBSCO Open Research、ScienceDirect、Wiley Online Library和b谷歌Scholar进行综合文献检索。审稿人根据预先规定的资格标准筛选潜在的文章。然后使用纽卡斯尔渥太华量表（NOS）评估符合条件的研究的偏倚风险，这是一种由Cochrane协作（ROB 2.0）开发的偏倚风险可视化工具。然后系统地提取和分析数据。结果14项研究共纳入139,879名受试者。ω -3脂肪酸摄入量≥500毫克/天显著降低48%的视力威胁糖尿病视网膜病变（DR）的风险（HR = 0.52; 95% CI: 0.31-0.88; p = 0.001）。亚组荟萃分析显示，与1型糖尿病（T1D）相比，2型糖尿病（T2D）的相关保护作用更强，合并风险比为0.71 （log HR = - 0.339; SE = 0.0667; p < 0.000001）。氧化应激标志物（MDA/TBARS）的合并平均差异为- 1.399 (95% CI: - 1.432至- 1.366;Z = 83.29; p < 0.00001)，无显著异质性（I²= 0%）。进一步分层在rct （HR = 0.743; p = 0.002）和非rct （HR = 0.514; p = 0.005）中均显示出强大的效果。这些发现支持omega-3作为预防DR的非药物干预，特别是在t2d中，可能通过抗炎和血管保护机制。结论：omega-3脂肪酸摄入与预防糖尿病视网膜病变的剂量依赖性保护有关，在全食物来源、最佳omega-6/omega-3比例和控制良好的T2D患者中获益最大。

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Association between omega-3 fatty acid intake and risk of diabetic retinopathy: A systematic review and meta-analysis

Background

Diabetic Retinopathy is a significant microvascular complication of diabetes mellitus characterized by progressive damage to the retinal vasculature. Current management strategies focus on modifying risk factors and treating established disease. Omega-3 polyunsaturated fatty acids (PUFAs) demonstrate anti-inflammatory, antioxidative, and vasculoprotective properties.

Objectives

To evaluate the protective effects of omega-3 fatty acids on DR incidence, progression, and microvascular health across diverse diabetic populations.

Methods

A comprehensive literature search was conducted via PubMed, EBSCO Open Research, ScienceDirect, Wiley Online Library, and Google Scholar. A reviewer screened the potential articles against prespecified eligibility criteria. The risk of bias in the eligible studies was then evaluated using the Newcastle Ottawa Scale (NOS), a Risk of Bias visualization tool developed by the Cochrane Collaboration (ROB 2.0). Data were then systematically extracted and analyzed.

Results

Fourteen studies involving 139,879 participants were analyzed. Omega-3 fatty acid intake of ≥500 mg/day significantly reduced the risk of sight-threatening diabetic retinopathy (DR) by 48% (HR = 0.52; 95% CI: 0.31–0.88; p = 0.001). Subgroup meta-analysis showed a stronger associated protective effect in type 2 diabetes (T2D) compared to type 1 (T1D), with a pooled hazard ratio of 0.71 (log HR = −0.339; SE = 0.0667; p < 0.000001). The antioxidant benefits were linked by a pooled mean difference of −1.399 in oxidative stress markers (MDA/TBARS) (95% CI: −1.432 to −1.366; Z = 83.29; p < 0.00001), with no significant heterogeneity (I² = 0%). Further stratification showed robust effects in both RCTs (HR = 0.743; p = 0.002) and non-RCTs (HR = 0.514; p = 0.005). These findings support omega-3s—especially in T2D—as a non-pharmacologic intervention for DR prevention, likely through anti-inflammatory and vasoprotective mechanisms.

Conclusion

Omega-3 fatty acid intake is associated with dose-dependent protection against diabetic retinopathy, with the greatest benefits from whole food sources, optimal omega-6/omega-3 ratios, and in well-controlled T2D patients.

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来源期刊

Journal of Nutrition Health & Aging 医学-老年医学

CiteScore

7.80

自引率

3.40%

发文量

136

审稿时长

4-8 weeks

期刊介绍： There is increasing scientific and clinical interest in the interactions of nutrition and health as part of the aging process. This interest is due to the important role that nutrition plays throughout the life span. This role affects the growth and development of the body during childhood, affects the risk of acute and chronic diseases, the maintenance of physiological processes and the biological process of aging. A major aim of "The Journal of Nutrition, Health & Aging" is to contribute to the improvement of knowledge regarding the relationships between nutrition and the aging process from birth to old age.