Omega‐3 fatty acids and endothelial function: A GRADE‐assessed systematic review and meta‐analysis

Introduction N‐3 polyunsaturated fatty acids (PUFAs) supplementation has been reported to have an impact on flow‐mediated dilatation (FMD), a conventionally used clinical technique for estimating endothelial dysfunction. However, its proven effects on endothelial function are unclear. This systematic review and meta‐analysis were conducted to evaluate the effects of n‐3 PUFAs supplementation on FMD of the brachial artery. Method This study was performed following the PRISMA guidelines. To identify eligible RCTs, a systematic search was completed in PubMed/Medline, Scopus and Web of Science using relevant keywords. A fixed‐ or random‐effects model was utilized to estimate the weighted mean difference (WMD) and 95% confidence interval (95% CI). Results Thirty‐two studies (with 35 arms) were included in this meta‐analysis, involving 2385 subjects with intervention duration ranging from 4 to 48 weeks. The pooled meta‐analysis demonstrated a significant effect of omega‐3 on FMD (WMD = 0.8%, 95% CI = 0.3–1.3, p = .001) and heterogeneity was significant ( I 2 = 82.5%, p < .001). Conclusion We found that n‐3 PUFA supplementation improves endothelial function as estimated by flow‐mediated dilatation of the brachial artery.