title: Long-chain n-3 PUFAs reduce adipose tissue and systemic inflammation in severely obese nondiabetic patients: a randomized controlled trial.
abstract: BACKGROUND
  Chronic adipose tissue inflammation is a hallmark of obesity, triggering the development of associated pathologies, particularly type 2 diabetes. Long-chain n-3 PUFAs reduce cardiovascular events and exert well-established antiinflammatory effects, but their effects on human adipose tissue inflammation are unknown.
  
  
  OBJECTIVE
  We investigated whether n-3 PUFAs reduce adipose tissue inflammation in severely obese nondiabetic patients.
  
  
  METHODS
  We treated 55 severely obese nondiabetic patients, scheduled to undergo elective bariatric surgery, with 3.36 g long-chain n-3 PUFAs/d (EPA, DHA) or an equivalent amount of butterfat as control, for 8 wk, in a randomized open-label controlled clinical trial. The primary efficacy measure was inflammatory gene expression in visceral and subcutaneous adipose tissue samples (subcutaneous adipose tissue and visceral adipose tissue), collected during surgery after the intervention. Secondary efficacy variables were adipose tissue production of antiinflammatory n-3 PUFA-derived eicosanoids, plasma concentrations of inflammatory markers, metabolic control, and the effect of the Pro12Ala PPARG polymorphism on the treatment response.
  
  
  RESULTS
  Treatment with n-3 PUFAs, which was well tolerated, decreased the gene expression of most analyzed inflammatory genes in subcutaneous adipose tissue (P < 0.05) and increased production of antiinflammatory eicosanoids in visceral adipose tissue and subcutaneous adipose tissue (P < 0.05). In comparison with control subjects who received butterfat, circulating interleukin-6 and triglyceride concentrations decreased significantly in the n-3 PUFA group (P = 0.04 and P = 0.03, respectively). The Pro12Ala polymorphism affected the serum cholesterol response to n-3 PUFA treatment.
  
  
  CONCLUSIONS
  Treatment with long-chain n-3 PUFAs favorably modulated adipose tissue and systemic inflammation in severely obese nondiabetic patients and improved lipid metabolism. These effects may be beneficial in the long-term treatment of obesity. This trial was registered at clinicaltrials.gov as NCT00760760.
authors.affiliation: Department of Medicine III, Clinical Division of Endocrinology and Metabolism, Medical University of Vienna, Vienna, Austria.
authors.forename: Bianca K
authors.initials: BK
authors.lastname: Itariu
authors.forename: Maximilian
authors.initials: M
authors.lastname: Zeyda
authors.forename: Eva E
authors.initials: EE
authors.lastname: Hochbrugger
authors.forename: Angelika
authors.initials: A
authors.lastname: Neuhofer
authors.forename: Gerhard
authors.initials: G
authors.lastname: Prager
authors.forename: Karin
authors.initials: K
authors.lastname: Schindler
authors.forename: Arthur
authors.initials: A
authors.lastname: Bohdjalian
authors.forename: Daniel
authors.initials: D
authors.lastname: Mascher
authors.forename: Suman
authors.initials: S
authors.lastname: Vangala
authors.forename: Michael
authors.initials: M
authors.lastname: Schranz
authors.forename: Michael
authors.initials: M
authors.lastname: Krebs
authors.forename: Martin G
authors.initials: MG
authors.lastname: Bischof
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Stulnig
mesh_terms: D000273:Adipose Tissue / Q000187:drug effects* / Q000502:physiology; D000328:Adult; D000368:Aged; D004247:DNA / Q000737:chemistry / Q000235:genetics; D005227:Fatty Acids / Q000097:blood; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007249:Inflammation / Q000097:blood / Q000188:drug therapy* / Q000235:genetics; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000188:drug therapy* / Q000235:genetics; D047495:PPAR gamma / Q000235:genetics; D016133:Polymerase Chain Reaction; D020641:Polymorphism, Single Nucleotide; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
chemical_list: D005227:Fatty Acids; D015525:Fatty Acids, Omega-3; D015850:Interleukin-6; D047495:PPAR gamma; D014280:Triglycerides; D004247:DNA