Impact of omega-3 fatty acids on hypertriglyceridemia, lipidomics, and gut microbiome in patients with type 2 diabetes.

IF 12.8 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Med Pub Date : 2024-08-13 DOI:10.1016/j.medj.2024.07.024

Jieli Lu, Ruixin Liu, Huahui Ren, Shuangyuan Wang, Chunyan Hu, Zhun Shi, Mian Li, Wei Liu, Qin Wan, Qing Su, Qifu Li, Hongting Zheng, Shen Qu, Fangming Yang, Hongyi Ji, Hong Lin, Hongyan Qi, Xueyan Wu, Kui Wu, Yuhong Chen, Yu Xu, Min Xu, Tiange Wang, Jie Zheng, Guang Ning, Ruizhi Zheng, Yufang Bi, Huanzi Zhong, Weiqing Wang

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Abstract

Background: Fish oil (FO), a mixture of omega-3 fatty acids mainly comprising docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), has been recommended for patients with type 2 diabetes (T2D) and hypertriglyceridemia. However, its effects on lipidomic profiles and gut microbiota and the factors influencing triglyceride (TG) reduction remain unclear.

Methods: We conducted a 12-week, randomized, double-blind, placebo-controlled trial in 309 Chinese patients with T2D with hypertriglyceridemia (ClinicalTrials.gov: NCT03120299). Participants were randomly assigned (1:1) to receive either 4 g FO or corn oil for 12 weeks. The primary outcome was changes in serum TGs and the lipidomic profile, and the secondary outcome included changes in the gut microbiome and other metabolic variables.

Findings: The FO group had significantly better TG reduction (mean [95% confidence interval (CI)]: -1.51 [-2.01, -1.01] mmol/L) compared to the corn oil group (-0.66 [-1.15, -0.16] mmol/L, p = 0.02). FO significantly altered the serum lipid profile by reducing low-unsaturated TG species and increasing those containing DHA or EPA. FO had minor effects on gut microbiota, while baseline microbial features predicted the TG response to FO better than phenotypic or lipidomic features, potentially mediated by specific lipid metabolites. A total of 9 lipid metabolites significantly mediated the link between 4 baseline microbial variables and the TG response to FO supplementation.

Conclusions: Our findings demonstrate differential impacts of omega-3 fatty acids on lipidomic and microbial profiles in T2D and highlight the importance of baseline gut microbiota characteristics in predicting the TG-lowering efficacy of FO.

Funding: This study was funded by the National Nature Science Foundation.

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欧米伽-3 脂肪酸对 2 型糖尿病患者高甘油三酯血症、血脂组学和肠道微生物组的影响。

背景：鱼油（FO）是一种主要由二十二碳六烯酸（DHA）和二十碳五烯酸（EPA）组成的ω-3脂肪酸混合物，已被推荐用于2型糖尿病（T2D）和高甘油三酯血症患者。然而，它对脂质组谱和肠道微生物群的影响以及影响甘油三酯（TG）降低的因素仍不清楚：我们在 309 名患有高甘油三酯血症的中国 T2D 患者中开展了一项为期 12 周的随机、双盲、安慰剂对照试验（ClinicalTrials.gov：NCT03120299）。参与者被随机分配（1:1）接受 4 克 FO 或玉米油，为期 12 周。主要结果是血清总胆固醇和脂质组谱的变化，次要结果包括肠道微生物组和其他代谢变量的变化：研究结果：膳食纤维组的血清总胆固醇降低率明显更高（平均值[95% 置信区间 (CI)]：-1.51 [-2.01 [-1.51]）：-0.66[-1.15，-0.16] mmol/L，p = 0.02）。FO 通过减少低不饱和 TG 种类和增加含有 DHA 或 EPA 的 TG 种类，明显改变了血清脂质谱。FO 对肠道微生物群的影响较小，而基线微生物特征比表型或脂质组特征更能预测 TG 对 FO 的反应，这可能是由特定脂质代谢物介导的。共有9种脂质代谢物对4种基线微生物变量与补充膳食纤维后的总胆固醇反应之间的联系有显著的中介作用：我们的研究结果表明了欧米伽-3脂肪酸对T2D患者血脂组和微生物特征的不同影响，并强调了基线肠道微生物群特征在预测FO降低总胆固醇疗效方面的重要性：本研究由国家自然科学基金资助。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Med MEDICINE, RESEARCH & EXPERIMENTAL-

CiteScore

17.70

自引率

0.60%

发文量

102

期刊介绍： Med is a flagship medical journal published monthly by Cell Press, the global publisher of trusted and authoritative science journals including Cell, Cancer Cell, and Cell Reports Medicine. Our mission is to advance clinical research and practice by providing a communication forum for the publication of clinical trial results, innovative observations from longitudinal cohorts, and pioneering discoveries about disease mechanisms. The journal also encourages thought-leadership discussions among biomedical researchers, physicians, and other health scientists and stakeholders. Our goal is to improve health worldwide sustainably and ethically. Med publishes rigorously vetted original research and cutting-edge review and perspective articles on critical health issues globally and regionally. Our research section covers clinical case reports, first-in-human studies, large-scale clinical trials, population-based studies, as well as translational research work with the potential to change the course of medical research and improve clinical practice.