Effect of omega-3 supplementation on lipid profile in children and adolescents: a systematic review and meta-analysis of randomized clinical trials
Masoud Khorshidi, Zohreh Sajadi Hazaveh, Malek Alimohammadi‐Kamalabadi, Sanaz Jamshidi, Omid Moradi Moghaddam, Beheshteh Olang, Sayeh Hatefi, Amirhossein Hosseini, Parsa Jamilian, Meysam Zarezadeh, Parichehr Behfarnia, Javad Heshmati, Parmida Jamilian, Aliakbar Sayyari
Abstract
Abstract Purpose Dyslipidemia is considered as a known risk factor for cardiovascular disease. Yet various trials with wide ranges of doses and durations have reported contradictory results. We undertook this meta-analysis of randomized controlled trials (RCTs) to determine whether omega-3 supplementation can affect lipid profile in children and adolescents. Methods Cochrane Library, Embase, PubMed, and Scopus databases were searched up to March 2021. Meta-analysis was performed using random-effect method. Effect size was expressed as weighted mean difference (WMD) and 95% confidence interval (CI). Heterogeneity was assessed using the I 2 index. In order to identification of potential sources of heterogeneity, predefined subgroup and meta-regression analysis was conducted. Results A total of 14 RCTs with 15 data sets were included. Based on the combination of effect sizes, there was a significant reduction in TG levels (WMD: -15.71 mg/dl, 95% CI: -25.76 to -5.65, P =0.002), with remarkable heterogeneity (I 2 =88.3%, P <0.001). However, subgroup analysis revealed that omega-3 supplementation significantly decreased TG only in studies conducted on participants ≤13 years old (WMD=-25.09, 95% CI: -43.29 to -6.90, P =0.007), (I 2 =84.6%, P <0.001) and those with hypertriglyceridemia (WMD=-28.26, 95% CI: -39.12 to -17.41, P <0.001), (I 2 =0.0%, P =0.934). Omega-3 supplementation had no significant effect on total cholesterol, HDL, and LDL levels. Also, results of nonlinear analysis showed significant effect of treatment duration on HDL status (P non-linearity =0.047). Conclusion Omega-3 supplementation may significantly reduce TG levels in younger children and those with hypertriglyceridemia. Also, based on the HDL-related results, clinical trials with longer duration of intervention are recommended in this population.