Effects of Omega‐3 Fatty Acids Intake on Lipid Metabolism and Plaque Volume in Patients With Coronary Heart Disease: A Systematic Review and Dose–Response Meta‐Analysis of Randomized Clinical Trials

Figures

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  FIGURE 1. Flowchart of the study selection process for randomized controlled trials (RCT) inclusion in the systematic review of the effects of omega‐3 fatty acids intake on lipid metabolism and plaque volume in patients with coronary heart disease.

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  FIGURE 2. Performance of each type of bias in all studies.

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  FIGURE 3. Forest plot illustrating the standardized mean difference and 95% confidence interval for the effects of omega‐3 fatty acids intake on triglyceride (TG) levels (SMD = −0.25, 95% CI = [−0.38, −0.11], I 2 = 41%, p = 0.024). CI, confidence interval; SMD, standardized mean difference.

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  FIGURE 4. Forest plot illustrating the standardized mean difference and 95% confidence interval for the effects of omega‐3 fatty acids intake on high‐density lipoprotein cholesterol (HDL‐C) levels (SMD = 0.08, 95% CI = [−0.03, 0.18], I 2 = 0%, p = 0.631). CI, confidence interval; SMD, standardized mean difference.

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  FIGURE 5. Forest plot illustrating the standardized mean difference and 95% confidence interval for the effects of omega‐3 fatty acids intake on low‐density lipoprotein cholesterol (LDL‐C) levels (SMD = −0.1, 95% CI = [−0.25, 0.04], I 2 = 46.8%, p = 0.012). CI, confidence interval; SMD, standardized mean difference.

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  FIGURE 6. Forest plot illustrating the standardized mean difference and 95% confidence interval for the effects of omega‐3 fatty acids intake on total cholesterol (TC) levels (SMD = −0.12, 95% CI = [−0.23, −0.02], I 2 = 37.3%, p = 0.044). SMD, CI, confidence interval; standardized mean difference.

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  FIGURE 7. Forest plot illustrating the standardized mean difference and 95% confidence interval for the effects of omega‐3 fatty acids intake on coronary artery plaque volume (SMD = −0.10, 95% CI = [−0.25, 0.05], I 2 = 0%, p = 0.504). CI, confidence interval; SMD, standardized mean difference.

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  FIGURE 8. Nonlinear dose–response analysis of the effects of omega‐3 fatty acids intake on lipid metabolism and arterial plaque volume in patients with coronary heart disease (REMR model analysis). Individual randomized clinical trial (RCT) are represented by circles, with the size of each circle corresponding to its weight in the overall analysis. The solid lines represent the estimated dose–response relationships for omega‐3 fatty acids intake on the circulating levels of (A) triglyceride (TG), (B) total cholesterol (TC), (C) low‐density lipoprotein cholesterol (LDL‐C), (D) high‐density lipoprotein cholesterol (HDL‐C), and (E) arterial plaque volume. The dashed lines represent the 95% confidence intervals (CI). REMR, robust error meta‐regression.