Effectiveness of n-3 fatty acids in the treatment of hypertriglyceridemia in HIV/AIDS patients: a meta-analysis

Vieira, Aline Doria Sobral; Silveira, Glória Regina Mesquita da

doi:10.1590/1413-81232017228.21752015

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REVIEW • Ciênc. saúde colet. 22 (8) • Aug 2017 • https://doi.org/10.1590/1413-81232017228.21752015 copy

Effectiveness of n-3 fatty acids in the treatment of hypertriglyceridemia in HIV/AIDS patients: a meta-analysis

Efetividade de ácidos graxos n-3 no tratamento da hipertrigliceridemia em pacientes com HIV/AIDS: uma meta-análise

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Hypertriglyceridemia is common in antiretroviral therapy-treated patients and Omega 3 fatty acids are being used as a intervention in reducing serum triglycerides (TG) in these patients. The objective of this study is to evaluate the effectiveness of the use of Omega 3 in the treatment of hypertriglyceridemia in HIV/AIDS patients on antiretroviral therapy. This study is a systematic review with meta-analysis of randomized clinical trials. Electronic databases – PubMed, Cochrane and Lilacs were researched. Fifty one articles were encountered. Nine were added to the meta-analysis. The reduction of triglycerides level was -77.55 mg (IC of -121.85 to -33.25) in Omega 3 groups. The analysis considering trials with more than 1000 mg of EPA/DHA included seven studies and the heterogeneity dropped to 0%.The reduction of combined averages was -101.56mg (IC of -145.76 to -57.37). The analysis considering trials with patients that had more than 200 mg/dL of initial triglycerides included also seven trials and the heterogeneity dropped to 0%. The reduction of combined averages was -114.15 mg (IC of -162.34 to -65.97). EPA/DHA supplementation reduces serum triglycerides levels in patients with HIV/AIDS-associated hypertriglyceridemia in stable use of antiretroviral therapy.

HIV; HAART; Triglycerides; Omega 3 and fish oil

Author/ Year/ Country	Method/timing (author/used)	Intervention (n)	Control (n)	Jadad	Results (tg)
Baril JG et al.¹⁵, 2007. Canada	Clinical Trial, randomized, controlled, crossover. 24 weeks (author). 12 weeks (used).	Salmon oil. EPA/DHA - 540/360mg. n = 26	Did not use placebo, did not receive oil (salmon) in the 12 initial weeks, but from 12^th -24^th weeks. n = 31	3	I		C
					mg/dL(SD)	mmol/L(SD)	mg/dL(SD)	mmol/L(SD)
					380,5 (203,5), reduction TG. P = 0.04	4.3 (2.3)	433.6 (212.3)	4.9 (2.4)
Peters BS et al.²⁶, 2012. England	Clinical trial, randomized Double-blind, controlled. 12 weeks.	Hypocholesterinic diet in use of fibrate or niacin. Omacor®. EPA/DHA - 1840/1520mg. n = 23	Hypocholesterinic diet in use of fibrate or niacin + placebo. n = 25	5	I		C
					mg/dL (SD)	mmol/L (SD)	mg/dL (SD)	mmol/L(SD)
					342.4 (168.1), reduction TG. p = 0.02	3.78 (1.90)	425.6 (272.5)	4.81 (3.08)
Carter et al.²⁵, 2006. Australia	Clinical trial, randomized Double-blind, controlled. 14 weeks.	Maxepa^®. EPA/DHA - 1620/1080mg. n = 5	Dietary guidance for 6 weeks (NHFG) placebo (olive oil). n = 6	4	I		C
					mg/dL (SD)	mmol/L (SD)	mg/dL (SD)	mmol/L(SD)
					203.5 (163.7), reduction TG. p = 0.04	2.3 (1.85)	361.1(163.7)	4.08 (1.85)
De Truchis et al.²⁷, 2007. France	Clinical trial, randomized Double-blind, controlled. crossover. 16 weeks (author). 8 weeks (used).	Maxepa^® EPA/DHA - 1080mg/720mg. n = 58	4 weeks diet (AHA) placebo. n = 62	5	I		C
					mg/dL (SD)	mmol/L (SD)	mg/dL (SD)	mmol/L (SD)
					340 (180), reduction TG. p = 0.003	3.8 (2.30)	480 (310)	5.4 (3.5)
Wohl et al.²⁸, 2005. USA	Clinical Trial, randomized, controlled. 16 weeks (author). 4 weeks (used).	Coromega^®. EPA/DHA - 1750/1150mg. n = 24.	Diet and physical activity (AHA), no placebo. n = 20	3	I		C
					mg/dL (SD)	mmol/L (SD)	mg/dL (SD)	mmol/L (SD)
					306 (162), redução TG. p = 0,007	3.4 (1.8)	503 (421)	5.6 (4.7)
Thusgaardet al..²⁹, 2009. Denmark	Clinical trial, randomized Double-blind, controlled. 12 weeks.	Omacor^® EPA/DHA - 1840/1520mg. n = 25	Placebo, 2 pills, 2g corn oil 2x/day. n = 23	4	I		C
					mg/dL (SD)	mmol/L (SD)	mg/dL (SD)	mmol/L (SD)
					134.5 (85.8), reduction TG. p = 0.03	1.52 (0.97)	178.7 (170.7)	2.02 (1.93)
Capili & Anastasi¹⁷, 2013. USA	Clinical trial, randomized Double-blind, controlled. 10 weeks (author). 8 weeks (used).	Diet (NCEP-TLC). Fish oil. EPA/DHA - 2400mg/1600mg n = 8	Diet (NCEP-TLC) placebo n = 10	4	I		C
					mg/dL (SD)	mmol/L (SD)	mg/dL (SD)	mmol/L (SD)
					169 (133), reduction TG. p = 0.013	1.90 (1.50)	289 (129)	3.26 (1.45)
Oliveira et al.¹⁶, 2014. Brazil	Clinical Trial, randomized, controlled. 24 weeks.	Fish oil. EPA/DHA - 540mg/365mg. n = 31	Placebo, 3g soy oil/day n = 35	3	I		C
					mg/dL (SD)	mmol/L (SD)	mg/dL (SD)	mmol/L (SD)
					141.7 (59.7), Non-significant reduction TG When compared with GC. p = 0.613	1.60 (0.67)	158.6 (59.0)	1.79 (0.66)
Paranandi A et al.¹⁴, 2014. USA	Clinical Trial, randomized, controlled. Crossover. 28 weeks (author) Washout (4 weeks) 12 weeks (used).	Lovaza^®. EPA/DHA - 1860/1500mg (12 weeks) n = 17	Placebo (12 weeks.), washout (4 weeks) and 4 pills of Lovaza^® (12 weeks). n = 19	5	I		C
					mg/dL (SD)	mmol/L (SD)	mg/dL (SD)	mmol/L (SD)
					215.6 (149.4), reduction TG. p = 0.001	2.43 (1.68)	335.6 (314.2)	3.79 (3.55)

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[1] Collaborations

ADS Vieira worked in reading of scientific articles, data extraction, data analysis and final manuscript; GRM Silveira worked in reading some of the scientific articles, data extraction, data analysis and final manuscript.