Fish Oil, Plasma n-3 PUFAs, and Risk of Macro- and Microvascular Complications Among Individuals With Type 2 Diabetes
Authors' conclusion
Habitual use of fish oil supplementation and higher plasma n-3 PUFA levels, especially DHA, were associated with lower risks of macrovascular and microvascular complications among individuals with type 2 diabetes, and the favorable associations were partially mediated through improving biomarkers of lipid profile and inflammation.
Study context
- Population
- People with T2D, UK Biobank; complications identified through hospital inpatient records
- Participants
- 20,338 people
- Exposure
- Fish oil use vs no use; plasma n-3 PUFA extreme quartiles
- Outcome
- Macrovascular and microvascular complications
- Follow-up
- 13.2 years
Methodological detailsUK Biobank, multivariable-adjusted
- UK Biobank
- Multivariable-adjusted
Main finding
As reported in the abstract
Fish oil vs No fish oilHazard ratio (95% CI)
Composite macrovascular complications
0.90(0.85–0.97)
Coronary heart disease
0.91(0.84–0.98)
Peripheral artery disease
0.72(0.61–0.83)
Composite microvascular complications
0.89(0.83–0.95)
DKD
0.87(0.79–0.95)
DR
0.88(0.80–0.97)
- Developed macrovascular complications
- 5396
- Developed microvascular complications
- 4868
Observational data: associations, not effects.
Further findings
Plasma n-3 PUFA levels and macro- and microvascular complications
- Higher n-3 PUFA levels, especially docosahexaenoic acid (DHA), were associated with lower risks of macrovascular and microvascular complications
- Multivariable adjusted
Plasma DHA, extreme quartiles compared
- Composite macrovascular complications, HR
- 0.68 (0.57, 0.81) (95% CI)
- Coronary heart disease (CHD), HR
- 0.63 (0.51, 0.77) (95% CI)
- Diabetic neuropathy, HR
- 0.59 (0.38, 0.91) (95% CI)
- Higher DHA associated with lower risks
Mediation by biomarkers (lipid profile and inflammatory markers) of plasma DHA associations
- Proportion explained, composite macrovascular complications
- 54.4%
- Proportion explained, CHD
- 63.1%
Original publication
Fish Oil, Plasma n-3 PUFAs, and Risk of Macro- and Microvascular Complications Among Individuals With Type 2 Diabetes. J Clin Endocrinol Metab. Published 12 July 2024. doi:10.
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