Long-chain n-3 PUFAs reduce adipose tissue and systemic inflammation in severely obese nondiabetic patients: a randomized controlled trial. Beneficial effects of n-3 polyunsaturated fatty acids on adiponectin levels and AdipoR gene expression in patients with type 2 diabetes mellitus: a randomized, placebo-controlled, double-blind clinical trial Effects of n-3 polyunsaturated fatty acids (PUFAs) on circulating adiponectin and leptin in subjects with type 2 diabetes mellitus. n-3 polyunsaturated fatty acids and adiponectin in patients with end-stage renal disease. The impact of long chain n-3 polyunsaturated fatty acid supplementation on inflammation, insulin sensitivity and CVD risk in a group of overweight women with an inflammatory phenotype. Serum adipokines as biomarkers of beta-cell function in patients with type 1 diabetes: positive association with leptin and resistin and negative association with adiponectin. Blood glucose lowering by means of lifestyle intervention has different effects on adipokines as compared with insulin treatment in subjects with type 2 diabetes Effects of n-3 pufas on fasting plasma glucose and insulin resistance in patients with impaired fasting glucose or impaired glucose tolerance. Treatment for 2 mo with n 3 polyunsaturated fatty acids reduces adiposity and some atherogenic factors but does not improve insulin sensitivity in women with type 2 diabetes: a randomized controlled study. Lifestyle Intervention and Adipokine Levels in Subjects at High Risk for Type 2 Diabetes Double-blind Randomized Placebo-controlled Clinical Trial of Omega 3 Fatty Acids for the Treatment of Diabetic Patients With Nonalcoholic Steatohepatitis Effects of n-6 PUFAs compared with SFAs on liver fat, lipoproteins, and inflammation in abdominal obesity: a randomized controlled trial. Long-term effects of n-3 fatty acids on serum lipids and glycaemic control. Additive benefits of long-chain n-3 polyunsaturated fatty acids and weight-loss in the management of cardiovascular disease risk in overweight hyperinsulinaemic women Effect of exercise training combined with phytoestrogens on adipokines and C-reactive protein in postmenopausal women: a randomized trial. Effect of statin and fibrate treatment on inflammation in type 2 diabetes. A randomized, cross-over study. Effect of fish oil (n-3 polyunsaturated fatty acids) on plasma lipids, lipoproteins and inflammatory markers in HIV-infected patients treated with antiretroviral therapy: A randomized, double-blind, placebo-controlled study
BACKGROUND Chronic adipose tissue inflammation is a hallmark of obesity , triggering the development of associated pathologies , particularly type 2 diabetes . Long-chain n-3 PUFAs reduce cardiovascular events and exert well-established antiinflammatory effects , but their effects on human adipose tissue inflammation are unknown . OBJECTIVE We investigated whether n-3 PUFAs reduce adipose tissue inflammation in severely obese nondiabetic patients . DESIGN We treated 55 severely obese nondiabetic patients , scheduled to undergo elective bariatric surgery  , with 3.36 g long-chain n-3 PUFAs/d ( EPA , DHA ) or an equivalent amount of butterfat as control , for 8 wk , in a r and omized open-label controlled clinical trial . The primary efficacy measure was inflammatory gene expression in visceral and subcutaneous adipose tissue sample s ( subcutaneous adipose tissue and visceral adipose tissue ) , collected during surgery after the intervention . Secondary efficacy variables were adipose tissue production of antiinflammatory n-3 PUFA-derived eicosanoids , plasma concentrations of inflammatory markers , metabolic control , and the effect of the Pro12Ala PPARG polymorphism on the treatment response . RESULTS Treatment with n-3 PUFAs , which was well tolerated , decreased the gene expression of most analyzed inflammatory genes in subcutaneous adipose tissue ( P < 0.05 ) and increased production of antiinflammatory eicosanoids in visceral adipose tissue and subcutaneous adipose tissue ( P < 0.05 ) . In comparison with control subjects who received butterfat , circulating interleukin-6 and triglyceride concentrations decreased significantly in the n-3 PUFA group ( P = 0.04 and P = 0.03 , respectively ) . The Pro12Ala polymorphism affected the serum cholesterol response to n-3 PUFA treatment . CONCLUSIONS Treatment with long-chain n-3 PUFAs favorably modulated adipose tissue and systemic inflammation in severely obese nondiabetic patients and improved lipid metabolism . These effects may be beneficial in the long-term treatment of obesity . This trial was registered at clinical trials.gov as NCT00760760 Introduction There is evidence that n-3 polyunsaturated fatty acids ( n-3 PUFAs ) exert beneficial effects to improve type 2 diabetes mellitus ( T2DM ) , but its complications remain poorly understood . Hypoadiponectinemia is one of the important mechanisms responsible for T2DM which necessitates developing novel therapeutic strategies . We aim ed to determine the effect of n-3 PUFA supplementation on circulating adiponectin and mRNA expression of adiponectin receptors ( AdipoR1 , AdipoR2 ) and Sirt-1 in T2DM patients . Material and methods A r and omized , double-blind , placebo-controlled trial of 10-week follow-up of n-3 PUFAs ( 2.7 g/day ) vs. placebo in T2DM patients ( n = 88 ) was conducted . In detail , T2DM patients ( n = 44 ) were treated with n-3 PUFAs and the remainder received placebo .  Anthropometric and metabolic characteristics were assessed in all participants .  Circulating level of adiponectin and mRNA expression of AdipoR1 , AdipoR2 and Sirt-1 were measured in peripheral blood mononuclear cells ( P BMC ) using real-time polymerase chain reaction before and after the intervention . Results It was found that n-3 PUFAs  increased AdipoR1 gene expression ( fold change = 1.321 in n-3 PUFAs vs. 1.037 in placebo ) and AdipoR2 mRNA ( fold change = 1.338 in n-3 PUFAs vs. 1.034 in placebo ) . No significant changes were observed for Sirt-1 expression . The serum level of adiponectin significantly ( p = 0.035 ) increased in n-3 PUFAs ( 5.09 to 5.58 μg/ml ) but remained unchanged in the placebo group . Conclusions Daily supplementation with n-3 PUFAs ( 2.7 g ) was effective to significantly improve gene expression of AdipoR1 and AdipoR2 and the serum level of adiponectin in T2DM patients . Therefore , n-3 PUFAs might emerge as an adjuvant for current antidiabetic therapies . However , confirmatory long-term studies are required Recent evidence suggests that omega-3 polyunsaturated fatty acids [ n-3 PUFAs : eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) ] , improve insulin sensitivity in humans . In a double-blind , placebo-controlled , r and omized , crossover study , we investigated the effects of EPA/DHA on paraoxonase-1 activity as well as fasting and postpr and ial levels of circulating adiponectin and leptin in 34 subjects with type 2 diabetes mellitus who received daily for 6 weeks either 2 g purified EPA/DHA or olive oil ( placebo ) , separated by a 6 weeks washout . At the end of each treatment , measurements were performed in fasting state and 2 , 4 , and 6 h following a st and ardized high-fat meal ( 600 kcal ) . No significant differences in fasting and postpr and ial circulating adiponectin , leptin , and paraoxonase-1 activity were seen between n-3 PUFAs and placebo . Our data do not support an insulin sensitizing effect of n-3 PUFAs by means of influencing circulating adipocytokines in this population . Clinical Trial Register Number : NCT00328536 BACKGROUND AND AIM In subjects without kidney disease , adiponectin appears to have anti-inflammatory , anti-diabetic , and anti-atherogenic effects . n-3 polyunsaturated fatty acids ( PUFA ) from seafood have several beneficial effects in patients with endstage renal disease ( ESRD ) and the aim of the present study was to assess the effect of n-3 PUFA supplementation on plasma adiponectin levels in ESRD patients . METHODS In a double blinded intervention trial , 162 ESRD patients ( mean age 67 years Â ± 13 , 56 women and 106 men ) undergoing chronic hemodialysis were r and omized to 1.7 g n-3 PUFA daily or placebo for 3 months . Adiponectin , plasma lipids and lipoproteins were measured at baseline and after the intervention period . RESULTS At baseline , adiponectin was positively correlated to HDL-cholesterol ( r = 0.55 , p < 0.001 ) and inversely correlated to plasma triglycerides , body mass index ( BMI ) and high sensitive C-reactive protein ( Hs-CRP ) ( r = -0.32 , p < 0.01 , r = -0.43 , p < 0.01 , and r = -0.21 , p < 0.01 , respectively ) . Furthermore , adiponectin was inversely correlated to the plasma levels of the two major n-3 PUFA docosahexaenoic acid ( DHA ) and eicosapentaenoic acid ( EPA ) ( r = -0.19 , p < 0.001 , and r = -0.30 , p < 0.001 , respectively ) . Baseline plasma adiponectin levels were high in both groups but after 3 months of supplementation no significant change was observed in the groups . Thus , n-3 PUFA supplementation did not change adiponectin levels . CONCLUSION We found an elevated plasma adiponectin level , which was inversely associated with plasma levels of DHA and EPA at baseline . Supplementation with n-3 PUFAs for 3 months did not change adiponectin levels . The negative result in this study may be related to a relatively low dose and future studies with higher dose and longer duration are needed to explore this mechanism BACKGROUND Inflammation is strongly related to obesity and the risk of cardiovascular disease ( CVD ) . The metabolic benefits of long chain ( LC ) n-3 polyunsaturated fatty acid ( PUFA ) may be attributable to its anti-inflammatory properties . OBJECTIVE To investigate whether an individual 's habitual inflammatory status influences the impact of a LC n-3 PUFA intervention on CVD risk . DESIGN The study was a r and omized crossover design . Subjects received LC n-3 PUFA capsules or a placebo for 12 weeks , with 4-week washout between phases . Thirty women , in the top and bottom tertiles of baseline sialic acid concentration , formed raised inflammatory status ( top , n = 12 ) and reference ( bottom , n = 18 ) groups . Baseline data were analysed using one-way anova , differences between treatment phases were calculated at each timepoint and analysed using a r and om effects model . RESULTS At baseline , the raised inflammatory status group had significantly higher body mass index and area under the curve ( AUC ) insulin than the reference group . With LC n-3 PUFA supplementation , both groups showed significantly higher plasma eicosapentaenoic acid and docosahexaenoic acid at 4 and 12 weeks ( p < 0.001 ) , and lower triacylglycerols ( 4 weeks p < 0.01 and 12 weeks p < 0.05 ) . The difference in AUC insulin between the two treatment phases at 12 weeks was significantly greater in the raised inflammatory status group compared to the reference group ( p < 0.05 ) . Inflammatory markers were significantly lower after 12 weeks LC n-3 PUFA supplementation compared to baseline ( C-reactive protein p < 0.05 and interleukin-6 p < 0.01 ) , but there was no significant group effect . CONCLUSIONS Habitual inflammatory status influences the impact of LC n-3 PUFA supplementation , but it is not clear whether the effect of LC n-3 PUFA on AUC insulin is mediated through inflammatory mechanisms BACKGROUND We investigated the adipokines adiponectin , leptin and resistin as serum biomarkers of beta-cell function in patients with type 1 diabetes . METHODS One hundred and eighteen patients with type 1 diabetes ( 20.3 ± 7.5 years ) diagnosed < 5 years underwent st and ardized mixed meal test ( MMTT ) for 2 h.  Systemic concentrations of C-peptide , adiponectin , leptin and resistin obtained during MMTT were measured and compared between patient groups by multiple regression analysis . RESULTS Patients were divided by their adipokine levels in subgroups above or below the median level ( ' high versus low ' ) . High adiponectin levels ( > 10.6 µg/mL ) were associated with lower C-peptide compared to the low adiponectin subgroup ( p < 0.03 ) . Increased leptin or resistin concentrations associated positively with beta-cell function even after adjustment for metabolic confounders ( p < 0.04 ) . The described associations between adipokines and C-peptide concentrations persisted in Spearman correlation tests ( p < 0.05 ) . Serum adipokines fell during MMTT ( p < 0.05 ) . CONCLUSIONS Serum adipokine levels differentially correlate with beta-cell function in type 1 diabetes independent of BMI or metabolic control . Serum adipokines should be investigated as biomarkers of beta-cell function in prospect i ve studies and intervention trials in type 1 diabetes Aims /hypothesisAdipokines may be important in mediating signals from adipocytes to insulin-sensitive tissue and vasculature . We studied the effect of different glucose-lowering therapies on serum levels of plasminogen activator inhibitor-1 ( PAI-1 ) , high-sensitivity C-reactive protein ( hs-CRP ) , TNF-α , leptin , adiponectin and ghrelin in patients with type 2 diabetes . Subjects and methods Twenty-eight patients with poorly controlled type 2 diabetes who were receiving oral hypoglycaemic agents  were allocated to one of the following groups , and treated for 1 year : ( 1 ) lifestyle intervention ( L ) ; ( 2 ) insulin treatment ( I ) ; and ( 3 ) combined treatment ( L+I ) . Results Similar improvements in glycaemic control occurred in all three groups . There was a reduction in body weight of 3.0 kg ( median ) ( 95 % CI −5.9 to −2.0 ) in group L , whereas in groups L+I and I body weight increased by 3.5 kg ( 95 % CI 1.5–4.9 ) and 4.9 kg ( 95 % CI −3.1 to 8.2 ) , respectively . By trend analyses , group L had reduced levels of PAI-1 ( p=0.002 ) , hs-CRP ( p<0.0001 ) and TNF-α ( p=0.006 ) , while no significant changes were observed in the levels of leptin or adiponectin . In group I , the median levels of PAI-1 ( p=0.008 ) , TNF-α ( p=0.058 ) and leptin ( p=0.004 ) increased . In the L+I group there was a reduction in PAI-1 levels ( p=0.014 ) and an increase in levels of leptin ( p<0.001 ) . The differences in changes in the levels of PAI-1 , hs-CRP , TNF-α and leptin between groups were also significant ( all p<0.01 ) . Conclusions /interpretationImprovement of glycaemic control through lifestyle intervention in type 2 diabetes had more beneficial effects on adipokine levels than when the same lowering of HbA1c was achieved with insulin treatment AIM to evaluate if a supplementation with n-3 PUFAs at high doses could give a regression of the condition of impaired glycemia . METHODS we enrolled 281 overweight/obese patients with impaired fasting glucose ( IFG ) or impaired glucose tolerance ( IGT ) ; 138 subjects were r and omized to n-3 PUFAs group , 1 g three times a day , and 143 to placebo for 18 months . We assessed at baseline , and after 9 , and 18 months : circumferences , body mass index ( BMI ) , fasting plasma glucose ( FPG ) , fasting plasma insulin ( FPI ) , HOMA-index , lipid profile . At baseline and at the end of the study , all patients underwent an oral glucose tolerance test ( OGTT ) . RESULTS we observed a decrease of glycemia and HOMA-IR with n-3 PUFAs , compared to baseline , and to placebo .  Fasting plasma insulin decreased with n-3 PUFAs and increased with placebo .  HDL-cholesterol increased after 18 months of n-3 PUFAs , while triglycerides decreased compared to baseline and to placebo . After OGTT performed at the end of the study , more patients returned to a condition of euglycemia with n-3 PUFAs compared to placebo . CONCLUSIONS n-3 PUFAs were effective in reducing glycemia in patients affected by IFG or IGT and seem to be helpful to slow the development of type 2 diabetes mellitus . © 2016 BioFactors , 42(3):316 - 322 , 2016 BACKGROUND Information is lacking on the potential effect of n-3 polyunsaturated fatty acids ( PUFAs ) on the adipose tissue of patients with type 2 diabetes . OBJECTIVE We evaluated whether n-3 PUFAs have additional effects on adiposity , insulin sensitivity , adipose tissue function ( production of adipokines and inflammatory and atherogenic factors ) , and gene expression in type 2 diabetes . DESIGN Twenty-seven women with type 2 diabetes without hypertriglyceridemia were r and omly allocated in a double-blind parallel design to 2 mo of 3 g/d of either fish oil ( 1.8 g n-3 PUFAs ) or placebo ( paraffin oil ) . RESULTS Although body weight and energy intake measured by use of a food diary were unchanged , total fat mass ( P < 0.019 ) and subcutaneous adipocyte diameter ( P < 0.0018 ) were lower in the fish oil group than in the placebo group . Insulin sensitivity was not significantly different between the 2 groups ( measured by homeostasis model assessment in all patients and by euglycemic-hyperinsulinemic clamp in a subgroup of 5 patients per group ) . By contrast , atherogenic risk factors , including plasma triacylglycerol ( P < 0.03 ) , the ratio of triacylglycerol to HDL cholesterol ( atherogenic index , P < 0.03 ) , and plasma plasminogen activator inhibitor-1 ( P < 0.01 ) , were lower in the fish oil group than in the placebo group . In addition , a subset of inflammation-related genes was reduced in subcutaneous adipose tissue after the fish oil , but not the placebo , treatment . CONCLUSIONS A moderate dose of n-3 PUFAs for 2 mo reduced adiposity and atherogenic markers without deterioration of insulin sensitivity in subjects with type 2 diabetes . Some adipose tissue inflammation-related genes were also reduced . These beneficial effects could be linked to morphologic and inflammatory changes in adipose tissue . This trial was registered at clinical trials.gov as NCT0037 OBJECTIVE —We investigated whether circulating adipokine concentrations can be altered by lifestyle intervention according to general recommendations in subjects at risk for diabetes as well as the potential of leptin , adiponectin , and resistin as biomarkers for lifestyle-induced improvements in glucose metabolism and insulin resistance . RESEARCH DESIGN AND METHODS —In the Study on Lifestyle intervention and Impaired glucose tolerance Maastricht , 147 men and women with impaired glucose tolerance ( IGT ) were r and omized to either a combined diet- and -exercise intervention or a control program . At baseline and after 1 year , an oral glucose tolerance test , an exercise test , and anthropometric measurements were performed . After 1 year , complete data of 103 subjects ( 50 intervention and 53 control subjects ) were obtained . RESULTS —Lifestyle intervention reduced plasma leptin concentrations ( −14.2 % ) in IGT subjects but did not alter plasma adiponectin ( −0.3 % ) or resistin ( −6.5 % ) concentrations despite marked improvements in glucose tolerance and insulin resistance . CONCLUSIONS —Changes in leptin concentration were related to improvements in insulin sensitivity independent of changes in body composition Background : Nonalcoholic steatohepatitis ( NASH ) is common and severe in patients with diabetes mellitus . Although , there are no effective treatments for NASH in diabetic patients , preliminary reports suggest that polyunsaturated fatty acids ( PUFA ) may be beneficial in these patients . Aim : A prospect i ve , r and omized , double-blind placebo-controlled study ( NCT 00323414 ) was performed in NASH patients with diabetes . Clinical trials.gov ( NCT 00323414 ) . Subjects and Methods : A total of 37 patients ( 50.6±9.8 y ) with well-controlled diabetes ( HbA1C<8.5 % ) were r and omized to receive either PUFA containing eicosapentaenoic acid ( 2160 mg ) and docosahexaenoic acid ( 1440 mg ) daily or an isocaloric , identical placebo containing corn oil for 48 weeks under CONSORT guidelines . Clinical , demographics , biochemical laboratory tests , body composition using DEXA , and liver biopsy were performed at r and omization and at the end of treatment . Liver biopsy was scored by the NASH CRN criteria . An intention-to-treat analysis was performed . Results : At inclusion , sex , age , body weight , biochemical tests , glucose control , and liver histology were similar in the 2 treatment groups . There was no change in liver enzymes , body weight , or body composition during the study in either group . At the end of the treatment , hepatic steatosis and the activity score improved ( P<0.05 ) and lobular inflammation worsened ( P<0.001 ) with placebo but was unchanged with PUFA . At the end of the treatment , insulin resistance ( serum glucose and HOMA ) worsened with PUFA but not placebo . Conclusions : PUFA provided no benefit over placebo in NASH patients with diabetes . The effects of PUFA on histology and insulin resistance were inferior to placebo . These data provide no support for PUFA supplements in NASH BACKGROUND Replacing SFAs with vegetable PUFAs has cardiometabolic benefits , but the effects on liver fat are unknown . Increased dietary n-6 PUFAs have , however , also been proposed to promote inflammation-a yet unproven theory . OBJECTIVE We investigated the effects of PUFAs on liver fat , systemic inflammation , and metabolic disorders . DESIGN We r and omly assigned 67 abdominally obese subjects ( 15 % had type 2 diabetes ) to a 10-wk isocaloric diet high in vegetable n-6 PUFA ( PUFA diet ) or SFA mainly from butter ( SFA diet ) , without altering the macronutrient intake . Liver fat was assessed by MRI and magnetic resonance proton ( 1H ) spectroscopy ( MRS ) . Proprotein convertase subtilisin/kexin type-9 ( PCSK9 , a hepatic LDL-receptor regulator ) , inflammation , and adipose tissue expression of inflammatory and lipogenic genes were determined . RESULTS A total of 61 subjects completed the study .  Body weight modestly increased but was not different between groups . Liver fat was lower during the PUFA diet than during the SFA diet [ between-group difference in relative change from baseline ; 16 % ( MRI ; P < 0.001 ) , 34 % ( MRS ; P = 0.02 ) ] . PCSK9 ( P = 0.001 ) , TNF receptor-2 ( P < 0.01 ) , and IL-1 receptor antagonist ( P = 0.02 ) concentrations were lower during the PUFA diet , whereas insulin ( P = 0.06 ) tended to be higher during the SFA diet . In compliant subjects ( defined as change in serum linoleic acid ) , insulin , total/HDL-cholesterol ratio , LDL cholesterol , and triglycerides were lower during the PUFA diet than during the SFA diet ( P < 0.05 ) . Adipose tissue gene expression was unchanged . CONCLUSIONS Compared with SFA intake , n-6 PUFAs reduce liver fat and modestly improve metabolic status , without weight loss . A high n-6 PUFA intake does not cause any signs of inflammation or oxidative stress . Downregulation of PCSK9 could be a novel mechanism behind the cholesterol-lowering effects of PUFAs . This trial was registered at clinical trials.gov as NCT01038102 The long-term influence of n-3 polyunsaturated fatty acids ( n-3 PUFAs ) on serum lipids and glucose homeostasis was studied in a group of non-diabetic , moderately hypertriglyceridaemic patients undergoing coronary artery bypass grafting .  They were investigated according to the same procedure before and 6 months after the operation . Following r and omization postoperatively , 28 patients received 3.4 g eicosapentaenoic and docosahexaenoic acid per day , whereas 29 patients comprised the control group . The decline in serum triglycerides after 6 months was significantly greater in the n-3 PUFA group than in the control group ( median decline , -33.2 % vs. -11.1 % , p = 0.002 ) , while no group difference was noted in serum total , HDL , or LDL cholesterol levels . Fasting plasma glucose levels decreased less in the n-3 PUFA group compared with the control group ( median change , -0.2 mmol l-1 vs. -0.5 mmol l-1 , p = 0.054 ) . The corresponding changes in fasting insulin levels were -2 mIU ml-1 in the n-3 PUFA group and no change in the control group ( p = 0.039 ) . In both groups combined , the recorded changes in serum triglyceride and serum insulin levels were negatively correlated with the change in serum phospholipid n-3 fatty acids ( r = -0.35 , p = 0.008 and r = -0.32 , p = 0.016 , respectively ) . An oral glucose tolerance test revealed no significant group differences after 6 months , neither in the peak levels , nor in the areas under the curves between 0 and 3h after the glucose load for glucose , insulin , and C-peptide . ( ABSTRACT TRUNCATED AT 250 WORDS Background : Obesity , inflammation , insulin resistance and cardiovascular disease ( CVD ) risk are inter-related . Both weight-loss and long-chain n-3 polyunsaturated fatty acids ( LC n-3 PUFA ) are independently known to reduce metabolic risk , but the combined effects are unclear . Objective : This study examines whether addition of LC n-3 PUFA to a low fat/high carbohydrate weight-loss programme results in greater improvements in inflammation , insulin sensitivity and CVD risk , than weight-loss alone . Design : One hundred and sixteen overweight insulin-resistant women entered a 24-week r and omised intervention study . Thirty-nine women were r and omised to a weight-loss programme , with LC n-3 PUFA ( WLFO ) , 38 to a weight-loss programme with placebo oil ( WLPO ) , and 39 to receive placebo oil , with no weight-loss programme ( control ) . Results : Ninety-three women completed the study ( 35 WLFO , 32 WLPO and 26 control ) , with significant weight-loss in WLFO ( 10.8±1.0 % ) and WLPO ( 12.4±1.0 % ) compared to the control group ( P<0.0001 ) . The WLFO , but not WLPO or control group , showed significant increases in adipose tissue LC n-3 PUFA ( 0.34±0.20 vs 0.17±0.10 and 0.16±0.10 % DHA , P<0.0001 ) . Weight-loss showed significant improvements in insulin sensitivity ( P<0.001 ) , lipid profile ( triglycerides P<0.05 ) and inflammation ( sialic acid P<0.05 ) . Time*group effects showed significant decreases in triglycerides ( P<0.05 ) and increases in adiponectin ( P<0.01 ) with LC n-3 PUFA , in the WLFO vs WLPO groups . Conclusions : Weight-loss improved risk factors associated with CVD , with some additional benefits of LC n-3 PUFA on triglycerides and adiponectin . Given the current low dietary intake of LC n-3 PUFA , greater attention should be given to increase these fatty acids in the treatment of obesity Phytoestrogens and training could be effective to reduce cardiovascular and type 2 diabetes mellitus risk factors in postmenopausal women . Nevertheless , the impact of their combination on adipokines and systemic inflammation was never investigated . The objective was to verify if 6 months of mixed training combined with phytoestrogens could have an additional effect on adipokine levels and systemic inflammation in obese postmenopausal women . Fifty-two obese women aged between 50 and 70 years were r and omly assigned to ( 1 ) exercise with placebo ( EX + PL ; n = 25 ) or ( 2 ) exercise with phytoestrogens ( EX + PHY ; n = 27 ) . Body weight , waist circumference , fat mass , and lean body mass ( dual-energy x-ray absorptiometry ) were assessed . Fasting plasma glucose and insulin , adiponectin , leptin , and C-reactive protein ( CRP ) levels were obtained after a 12-hour overnight fast . Total energy intake was measured with a 3-day dietary record . All measurements were performed before and after the 6-month intervention . Although energy intake remained unchanged , body composition was improved in all women ( all Ps < .02 ) . Plasma CRP and leptin levels decreased in both groups similarly ( all Ps < .03 ) , whereas plasma adiponectin and insulin did not change with exercise combined with placebo or phytoestrogens . Correlation analyses showed that homeostasis model assessment of insulin resistance ( r = -0.58 , P = .02 ) and fasting insulin levels ( r = -0.42 , P = .02 ) at baseline were both correlated with changes in leptin levels . Baseline fasting glucose ( r = -0.36 , P = .03 ) and adiponectin ( r = 0.45 , P = .005 ) levels were associated with changes in CRP concentrations . Although mixed exercise program combined with phytoestrogens does not seem to provide any additional effect , mixed training improves systemic inflammation and leptin concentrations in obese postmenopausal women A r and omized , crossover study compared the effects of atorvastatin , gemfibrozil and their combination on inflammatory markers in type 2 diabetes .  C-reactive protein ( CRP ) , lipoprotein-associated phospholipase A2 ( Lp-PLA2 ) , secretory phospholipase A2 ( sPLA2 ) , interleukin 8 ( IL8 ) , monocyte chemotactic protein 1 ( MCP1 ) and tumor necrosis factor α ( TNFα ) were measured . Both lipid-lowering drugs had positive , complementary and additive effects on inflammatory markers , which were closely related to baseline inflammatory status Patients on  antiretroviral therapy  are reported to have an increased risk of cardiovascular disease . We aim ed to investigate the effect of n-3 polyunsaturated fatty acids ( n-3 PUFAs ) on plasma lipids , lipoproteins and inflammatory markers in HIV-infected patients treated with antiretroviral therapy .  We r and omized 51 patients in a placebo-controlled , double-blind trial to receive either 2 capsules of Omacor ® twice daily or 2 capsules of placebo .  Compliance was measured by determining levels of eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) in neutrophils . Plasma triglycerides were reduced in the n-3 PUFA group by 0.14 mmol/l after 12 weeks of treatment ( n=26 ) , while plasma triglycerides increased by 0.36 mmol/l in the control group ( n=25 ) . The difference between groups was significant , p=0.03 . No significant effect of treatment was found for total cholesterol , high-density lipoprotein ( HDL ) or low-density lipoprotein ( LDL ) cholesterol or apolipoproteins . There was a significant increase in leukotriene B5 ( LTB5 ) and LTB5/LTB4 ratio in the n-3 PUFA group compared to the control group . Baseline values for intercellular adhesion molecule-1 ( ICAM ) , vascular cell adhesion molecule-1 ( VCAM ) and highly sensitive C-reactive protein ( hsCRP ) were comparable at baseline , and the intervention did not change these parameters significantly . The present study showed that treatment with n-3 PUFA  slightly decreased plasma triglycerides and induced anti-inflammatory effects by increasing formation of anti-inflammatory LTB5
Conclusion Plant and marine sources of n-3 PUFAs can modify serum leptin and adiponectin levels by increasing adiponectin and decreasing leptin levels in patients with type 2 diabetes .
Due to some limitations in this study , further studies are needed to reach a definitive conclusion about the effect of n-3 PUFAs on the levels of leptin and adiponectin in T2DM
Abstract Aim N-3 PUFAs can potentially influence levels of inflammatory and non-inflammatory adipokines .
Given the contradictory effects of n-3 PUFAs on serum levels of adipokines in type 2 diabetes , we conducted a systematic review and meta- analysis study of r and omized placebo-controlled clinical trials that examined the effects of n-3 PUFAs on serum levels of leptin and adiponectin in patients with type 2 diabetes .