title: The Effect of n-3 Polyunsaturated Fatty Acid Supplementation on Androgen Status in Patients with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Clinical Trials.
abstract: The anti-androgenic role of n-3 polyunsaturated fatty acids (PUFAs) among patients with polycystic ovary syndrome (PCOS) has recently been proposed. The present study aimed to systematically review clinical trials assessing the effects of n-3 PUFAs consumption on androgen status among adult females with PCOS. PubMed, ISI Web of Science, Google Scholar, and Scopus were searched up to December 2015. Clinical investigations assessing the effect of n-3 PUFAs on adult females with PCOS were included. Mean±standard deviation of change in serum total testosterone, sex hormone binding globulin (SHBG), and dehydroepiandrostrone sulfate (DHEAS) were extracted. Eight clinical trials with 298 participants were eligible. Meta-analysis showed that n-3 PUFAs supplementation marginally reduces total testosterone (mean difference [MD]: - 0.19 nmol/l; 95% CI: - 0.39 to 0.00; p=0.054), but not SHBG (MD: 1.75 nmol/l; 95% CI: -0.51 to 4.01; p=0.129) or serum DHEAS levels (Hedes' g: -0.11 nmol/l; 95% CI: -0.29 to 0.06; p=0.19) among adult females with PCOS. Subgroup analyses showed that only before-after studies (Hedges' g: 0.15; 95% CI: -0.27 to -0.04; p=0.01) and long-term interventions (>6 weeks) (Hedges' g: -0.17; 95% CI, -0.29 to -0.05; p=0.004) had reducing effects on serum DHEAS levels. The majority of long-term trials utilized a single group design (no control group). It does not appear that n-3 PUFAs supplementation significantly affects the androgenic profile of females with PCOS; however, some before-after and long-term intervention studies show reduced DHEAS levels. Future studies incorporating double blinded placebo controlled clinical trials with long follow-up periods are warranted.
authors.affiliation: Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Hajishafiee
authors.affiliation: Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: G
authors.initials: G
authors.lastname: Askari
authors.affiliation: Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: B
authors.initials: B
authors.lastname: Iranj
authors.affiliation: Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: R
authors.initials: R
authors.lastname: Ghiasvand
authors.affiliation: School of Nutrition, Ryerson University, Victoria Street, Toronto, Ontario, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Bellissimo
authors.affiliation: School of Nutrition, Ryerson University, Victoria Street, Toronto, Ontario, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Totosy de Zepetnek
authors.affiliation: Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: A
authors.initials: A
authors.lastname: Salehi-Abargouei
mesh_terms: D000728:Androgens / Q000097:blood*; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D019587:Dietary Supplements; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000188:drug therapy*; D017594:Publication Bias; D016032:Randomized Controlled Trials as Topic; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013739:Testosterone / Q000097:blood
chemical_list: D000728:Androgens; D015525:Fatty Acids, Omega-3; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate