The Effects of n -3 PUFA Supplementation on Bone Metabolism Markers and Body Bone Mineral Density in Adults: A Systematic Review and Meta-Analysis of RCTs

• Published in: Nutrients Vol. 15; no. 12; p. 2806
• Main Authors: Gao, Jie, Xie, Chenqi, Yang, Jie, Tian, Chunyan, Zhang, Mai, Lu, Zhenquan, Meng, Xiangyuan, Cai, Jing, Guo, Xiaofei, Gao, Tianlin
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 19.06.2023; MDPI
• Subjects: 25-Hydroxyvitamin D; Adult; Biomarkers; Bone Density; bone health; bone metabolism; Bone mineral density; Bone turnover; Calcium; Calcium (blood); Calcium - pharmacology; Collagen; Cytokines; Dietary Supplements; Fatty acids; Fatty Acids, Omega-3 - pharmacology; Fatty Acids, Omega-3 - therapeutic use; Fatty Acids, Unsaturated - pharmacology; Female; Fractures; Homeostasis; Humans; Interleukin 6; Intervention; Meta-analysis; Metabolism; n-3 PUFA; Osteoporosis; Parathyroid hormone; Post-menopause; Subgroups; supplementation; Systematic Review; Vitamin D; White people; supplementation; bone metabolism; n-3 PUFA; bone health
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu15122806

Supplemental -3 polyunsaturated fatty acids (PUFA) on bone metabolism have yielded inconsistent results. This study aimed to examine the effects of -3 PUFA supplementation on bone metabolism markers and bone mineral density through a meta-analysis of randomized controlled trials. A systematic literature search was conducted using the PubMed, Web of Science, and EBSCO databases, updated to 1 March 2023. The intervention effects were measured as standard mean differences (SMD) and mean differences (MD). Additionally, -3 PUFA with the untreated control, placebo control, or lower-dose -3 PUFA supplements were compared, respectively. Further, 19 randomized controlled trials (RCTs) (22 comparisons, n = 2546) showed that -3 PUFA supplementation significantly increased blood -3 PUFA (SMD: 2.612; 95% CI: 1.649 to 3.575). However, no significant effects were found on BMD, CTx-1, NTx-1, BAP, serum calcium, 25(OH)D, PTH, CRP, and IL-6. Subgroup analyses showed significant increases in femoral neck BMD in females (0.01, 95% CI: 0.01 to 0.02), people aged <60 years (0.01, 95% CI: 0.01 to 0.01), and those people in Eastern countries (0.02, 95% CI: 0.02 to 0.03), and for 25(OH)D in people aged ≥60 years (0.43, 95% CI: 0.11 to 0.74), treated with -3 PUFA only (0.36, 95% CI: 0.06 to 0.66), and in studies lasting ≤6 months (0.29, 95% CI: 0.11 to 0.47). NTx-1 decreased in both genders (-9.66, 95% CI: -15.60 to -3.71), and serum calcium reduction was found in studies lasting >6 months (-0.19, 95% CI: -0.37 to -0.01). The present study demonstrated that -3 PUFA supplementation might not have a significant effect on bone mineral density or bone metabolism markers, but have some potential benefits for younger postmenopausal subjects in the short term. Therefore, additional high-quality, long-term randomized controlled trials (RCTs) are warranted to fully elucidate the potential benefits of -3 PUFA supplementation, as well as the combined supplementation of -3 PUFA, on bone health.