title: The limited effect of omega-3 polyunsaturated fatty acids on cardiovascular risk in patients with impaired glucose metabolism: a meta-analysis.
abstract: OBJECTIVE
  The impacts of marine-derived n-3 polyunsaturated fatty acids (n-3 PUFAs) on cardiovascular risk are not well known. We conducted this meta-analysis to determine the effects of n-3 PUFAs on cardiovascular outcomes and cardiovascular risk markers in patients with impaired glucose metabolism (IGM).
  
  
  METHODS
  We searched PUBMED, EMBASE, The Cochrane Library and reference lists of relevant papers for high quality randomized controlled trials comparing dietary intake of n-3 PUFAs with placebo in IGM patients. Data was extracted and quality assessed independently by two reviewers. Authors were contacted for missing information. Overall estimates were calculated using a random-effects model or a fixed-effects model, and the possibility of publication bias was examined using a funnel plot. Subgroup analyses were conducted to explore the association between the risk markers and study characteristics.
  
  
  RESULTS
  Our meta-analysis included 19 studies, 24,788 patients. Compared with placebo, n-3 PUFAs had no statistically significant reduce effect on cardiovascular mortality, major cardiovascular events, all-cause mortality or composite endpoint of all-cause mortality or hospitalization for cardiovascular cause, however it can significantly reduce the level of triglycerides (weighted mean difference [WMD] -0.25mmol/L; 95% CI -0.37 to -0.13: p<0.001; 12 trials, 13,921 patients).
  
  
  CONCLUSIONS
  Marine-derived n-3 polyunsaturated fatty acids have no protective effect on cardiovascular mortality, major cardiovascular events, all-cause mortality and composite endpoint of all-cause mortality or hospitalization for cardiovascular cause in IGM patients, but can reduce triglyceride level.
authors.affiliation: Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Department of Cardiology, Qilu Hospital of Shandong University, Jinan 250012, PR China.
authors.forename: Tengfei
authors.initials: T
authors.lastname: Zheng
authors.affiliation: Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Department of Cardiology, Qilu Hospital of Shandong University, Jinan 250012, PR China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Department of Cardiology, Qilu Hospital of Shandong University, Jinan 250012, PR China.
authors.forename: Yushu
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Tianjin Medical University General Hospital, Tianjin 300052, PR China.
authors.forename: Wennan
authors.initials: W
authors.lastname: Liu
authors.affiliation: Key Laboratory of Cardiovascular Proteomics of Shandong Province, Department of Geriatrics, Qilu Hospital of Shandong University, Jinan 250012, PR China.
authors.forename: Zhihao
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Department of Cardiology, Qilu Hospital of Shandong University, Jinan 250012, PR China.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Shang
authors.affiliation: Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Department of Cardiology, Qilu Hospital of Shandong University, Jinan 250012, PR China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Department of Cardiology, Qilu Hospital of Shandong University, Jinan 250012, PR China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Department of Cardiology, Qilu Hospital of Shandong University, Jinan 250012, PR China. Electronic address: sduzhongming@gmail.com.
authors.forename: Ming
authors.initials: M
authors.lastname: Zhong
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000097:blood / Q000378:metabolism* / Q000503:physiopathology; D005215:Fasting / Q000097:blood; D015525:Fatty Acids, Omega-3 / Q000494:pharmacology*; D018740:Genetic Heterogeneity; D005947:Glucose / Q000378:metabolism*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006339:Heart Rate; D006801:Humans; D008055:Lipids / Q000097:blood; D017594:Publication Bias; D012307:Risk Factors; D016896:Treatment Outcome; D014664:Vasodilation / Q000187:drug effects
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D015525:Fatty Acids, Omega-3; D005947:Glucose; D006442:Glycated Hemoglobin; D008055:Lipids
keywords: Cardiovascular risk markers; Docosahexaenoic acid; Eicosapentaenoic acid; Impaired glucose metabolism; Omega-3 polyunsaturated fatty acids