Efficacy of omega-3 polyunsaturated fatty acids on hormones, oxidative stress, and inflammatory parameters among polycystic ovary syndrome: a systematic review and meta-analysis

Background: There is a close relationship between hormones, oxidative stress, and inflammatory factors and polycystic ovary syndrome (PCOS). This meta-analysis was conducted to evaluate the changes in hormones, oxidative stress, and inflammatory factors of PCOS patients who were supplemented with omega-3 polyunsaturated fatty acids (n-3 PUFAs). Methods: The databases of PubMed, Cochrane Library, Em base, and Web of Science were searched from inception to February 2021. We have included all randomized controlled trials (RCTs) that reported the n-3 PUFA treatment in PCOS. Weighted mean differences (WMD) and 95% confidence interval (CI) were calculated, and either the fixed effects model or random effects model was used. Results: 314 studies were initially identified, and 10 RCTs with 610 patients were finally included in the current study. Results suggested that PCOS patients with n-3 PUFAs supplementation may have a reduction in C-reactive protein (CRP; -8.97 mg/dL; 95% CI: -17.66 to -0.28 mg/dL; P=0.04; I-2 =99%); serum malondialdehyde (MDA; -0.40 mg/dL; 95% CI: -0.56 to -0.25 mg/dL; P<0.00001; I-2 =42); luteinizing hormone (LH; -1.33 mg/dL; 95% CI: -2.63 to -0.04 mg/dL; P=0.04; I-2 =0%); serum total testosterone (TT; -0.11 mg/dL; 95% CI: -0.18 to -0.04 mg/dL; P=0.02; I-2 =73%); and an increase in total antioxidant capacity (TAC; -0.57 mg/dL; 95% CI: 22.32 to 122.16 mg/dL; P=0.005; I-2 =50%) and serum sex hormone binding globulin (SHBG; 0.68 mg/dL; 95% CI: 0.06 to 1.31 mg/dL; P=0.03; I-2 =0%).However, no effect on glutathione (GSH; -0.57 mg/dL; 95% CI: -50.34 to 25.07 mg/dL; P=0.51; I-2 =56%), dehydroepiandrosterone sulfate (DHEAS; -6.87 mg/dL; 95% CI: -1.53 to 1.50 mg/dL; P=0.99; I-2 =78%), free androgen index (FM; 0.00 mg/dL; 95% CI: -0.03 to 0.03 mg/dL; P=0.99; I-2 =0%), or follicle-stimulating hormone (FSH; 0.37 mg/dL; 95% CI: -0.55 to 1.29 mg/dL; P=0.43; I-2 =61) was found. Conclusions: This meta-analysis showed that supplementation of n-3 PUFAs in PCOS women can significantly improve CRP, MDA, LH, TT, TAC, and SHBG, but did not affect the concentrations of GSH, DHEAS, FM, or FSH.