Impact of omega-3 supplementation on lipoprotein-associated phospholipase A2 mass and activity: A systematic review and meta-analysis of randomized controlled trials.

Abstract

<h4>Background</h4>Omega-3 polyunsaturated fatty acid (PUFA) administration has been associated with a reduced risk of developing cardiovascular diseases. Some studies have explored the potential effect of omega-3 PUFA on lipoprotein-associated phospholipase A2 (Lp-PLA2) levels with conflicting results; while some have shown no effect, others have found reduced levels of Lp-PLA2 with omega-3 supplementation. This meta-analysis of randomized controlled trials aims to clarify the impact of omega-3 supplementation on Lp-PLA2 mass and activity.<h4>Sources of material</h4>The Medical Subject Headings (MeSH) terms and keywords were searched in Web of Science, PubMed, Scopus, Google Scholar, and ClinicalTrials.gov databases. The random- or fixed-effects model and the generic inverse variance weighting method were applied for quantitative data. The influence of each study on the overall effect size was determined using the leave-one-out method.<h4>Abstract of findings</h4>The meta-analysis of 16 randomized controlled trials showed a significant reduction in Lp-PLA2 mass with omega-3 intervention (weighted mean difference [WMD]: -24.05 ng/mL, 95% CI: -27.63, -20.47, P < .0001) but no significant changes in Lp-PLA2 activity (WMD: -8.54 nmol/mL/min, 95% CI: -27.25, 10.18, P = .37). A subgroup analysis by type of omega-3 supplementation revealed that either icosapent ethyl (WMD: -32.67 ng/mL, 95% CI: -34.36, -30.98, P < .00001) or other omega-3 formulations (WMD: -17.05 ng/mL, 95% CI: -22.93, -11.18, P < .00001) significantly decreased the Lp-PLA2 mass.<h4>Conclusion</h4>Omega-3 supplementation significantly reduces circulating levels of Lp-PLA2 mass without affecting its activity.