The effects of ω-3 fatty acids on inflammatory and oxidative stress markers in patients with Type 2 diabetes mellitus: A systematic review and meta-analysis of controlled trials.

BACKGROUND & AIMS: Taking into account the anti-inflammatory and antioxidant properties of omega-3 fatty acids and the evidence indicating the role of chronic inflammation and oxidative stress in the pathophysiology diabetes, this study aimed to determine the effect of ω-3 fatty acids on oxidative stress and inflammatory markers in Type 2 diabetes mellitus (T2DM) patients. METHODS: A systematic search up to July 30, 2023 was completed in Scopus, PubMed, Web of Science, and Embase databases, to identify eligible RCTs. Heterogeneity tests of the selected studies were performed using the I2. Random effects models were assessed and pooled data were determined as standardized mean differences (SMD) with a 95 % CI. RESULTS: The meta-analysis of 23 trials, involving 1523 patients, demonstrated a significant decrease in TNF-α (SMD: -1.62, 95 % CI: -2.89 to -0.35, P= 0.013) and increase in TAC (SMD: 0.92, 95 % CI: 0.33-1.52, P = 0.002) following ω-3 fatty acids administration. Meanwhile, supplementation did not have beneficial effects on malondialdehyde, C-reactive protein (CRP), superoxide dismutase (SOD), and interlukin-6 levels. The subgroup analysis revealed a significant decrease in CRP levels and an increase in SOD levels in studies with durations of less than 12 weeks. CONCLUSIONS: We found that ω-3 fatty acid intake can significantly decrease TNF-α and increase TAC levels, but this effect was not observed on other markers. Nevertheless, future well-designed with large sample size and long duration RCT studies with precise ω-3 fatty acids dose and ingredients are required to understand better the effects of these compounds and their constituents on oxidative stress and inflammatory markers in T2DM patients.