Effects of an Omega-3 and Vitamin D Supplement on Fatty Acids and Vitamin D Serum Levels in Double-Blinded, Randomized, Controlled Trials in Healthy and Crohn’s Disease Populations
Abstract
:1. Introduction
2. Materials and Methods
2.1. Capsules for the Intervention and Placebo
2.2. Outcome Measurements
2.3. Statistical Analysis
2.4. Trial Registration
3. Results
4. Discussion
4.1. EPA (C20:5), DHA (C22:6), and DPA (C22:5)
4.2. Omega-3 Index
4.3. Vitamin D
4.4. CRP
4.5. Calprotectin
4.6. Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Appendix A
Demographics | Phenotypes | ||||||
---|---|---|---|---|---|---|---|
Number | % | Disease Location | Number | % | |||
Gender | Male | 7 | 28 | OGD | 0 | 0 | |
Female | 17 | 68 | Jejunal | 1 | 4 | ||
Age of diagnosis | % | Ileal | 9 | 36 | |||
<17 (A1) | 1 | 4 | Colonic | 7 | 28 | ||
17–40 (A2) | 22 | 92 | Ileal-Colonic | 6 | 24 | ||
>40 (A3) | 1 | 4 | Rectal | 1 | 4 | ||
Family history | Anal | 1 | 4 | ||||
Yes | 3 | 12 | Disease Behaviour | ||||
No | 5 | 20 | Inflammatory | 13 | 52 | ||
Missing | 17 | 68 | Stenotic | 10 | 40 | ||
Smoking status | Fistulating | 4 | 16 | ||||
Smoker | 2 | 8 | Peri-anal | 4 | 16 | ||
Ex-smoker | 7 | 28 | Other | 0 | 0 | ||
Non-smoker | 16 | 64 | Surgery | None | 9 | 36 | |
Infant History | Yes | 17 | 68 | ||||
Breast fed | 15 | 63 | EIM/Other disorders | ||||
Caesarean Section | 1 | 4 | Joints | 4 | 17 | ||
Abbreviation: | Skin | 3 | 13 | ||||
OGD: Oesophagogastroduodenoscopy | Eyes | 0 | 0 |
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Measure | Details |
---|---|
Eicosapentaenoic acid (EPA) | µg/mL, C20:5 |
Docosapentaenoic acid (DPA) | µg/mL, C22:5 |
Docosahexaenoic acid (DHA) | µg/mL, C22:6 |
Omega-3 index (using serum measures) | µg/mL, sum of EPA and DHA |
Calprotectin | µg/g |
C-reactive protein | mg/L, reference range 0.5–5 |
Vitamin D | nmol/L, serum 25(OH)D |
Measure, Units | Group A n (%) or Median (Q1, Q3) | Group B n (%) or Median (Q1, Q3) |
---|---|---|
Healthy Participants | N = 15 | N = 14 |
Male | 6 (40%) | 8 (57%) |
Past Smoker | 4 (27%) | 1 (7%) |
Non-European Ethnicity | 4 (27%) | 4 (29%) |
Age, years | 48.2 (26, 54) | 50.9 (26.8, 54.3) |
Height, cm | 171 (163, 176) | 173 (167, 178) |
Weight, kg | 69.7 (59.3, 84.1) | 75.1 (58.9, 95.8) |
BMI, kg/m2 | 23.2 (21.5, 28.0) | 24.1 (21.0, 27.7) |
Crohn’s Disease Participants | N = 13 | N = 12 |
Male | 4 (31%) | 3 (25%) |
Past Smoker | 3 (23%) | 4 (33%) |
Non-European Ethnicity | 0 | 0 |
Age, years | 49.0 (43.0, 58.0) | 46.5 (42.0, 51.0) |
Height, cm | 168 (163, 179) | 165 (161, 174) |
Weight, kg | 81.4 (75.0, 88.8) | 78.1 (68.8, 81.1) |
BMI, kg/m2 | 27.3 (23.6, 29.0) | 26.6 (24.8, 30.0) |
Measure | Group | T1, Median (Q1, Q3) * | T2, Median (Q1, Q3) | T3, Median (Q1, Q3) | T4, Median (Q1, Q3) |
---|---|---|---|---|---|
Healthy Participants | (N = 29) | (N = 29) | (N = 28) | (N = 27) | |
EPA, µg/mL | A | 29.3 (23.0, 40.1) | 26.6 (19.9, 32.2) | 24.6 (17.4, 28.4) | 66.4 (58.9, 72.6) |
B | 28.4 (22.3, 34.0) | 75.6 (61.8, 106) | 32.5 (27.4, 40.1) | 33.8 (19.0, 40.1) | |
DPA, µg/g | A | 18.5 (14.1, 20.9) | 16.0 (11.6, 18.5) | 14.5 (13.1, 17.6) | 21.2 (17.0, 22.5) |
B | 15.9 (14.8, 19.8) | 19.5 (17.1, 26.1) | 16.6 (14.1, 18.5) | 17.2 (14.5, 19.1) | |
DHA, µg/g | A | 63.0 (55.6, 95.3) | 59.5 (51.7, 75.4) | 59.9 (53.2, 71.9) | 81.3 (76.4, 93.8) |
B | 60.1 (42.5, 79.9) | 85.7 (76.2, 101) | 57.8 (52.0, 84.3) | 63.3 (47.9, 71.6) | |
Omega-3 index (EPA + DHA), µg/mLUsing serum measures | A | 88.7 (80.5, 128) | 86.6 (70.3, 106) | 79.2 (73.9, 98.0) | 156 (120, 163) |
B | 87.2 (72.8, 110) | 162 (140, 206) | 89.4 (79.5, 119) | 88.8 (72.5, 122) | |
Vitamin D -25(OH)D, nmol/L | A | 70.0 (63.0, 76.0) | 62.0 (59.0, 70.0) | 58.5 (49.0, 67.0) | 64.0 (54.0, 68.0) |
B | 62.0 (56.0, 67.0) | 65.0 (61.0, 75.0) | 58.0 (50.0, 66.0) | 46.0 (40.0, 64.0) | |
Calprotectin, µg/g | A | 32.0 (20.4, 62.9) | 25.2 (23.1, 43.9) | 18.2 (10.4, 33.6) | 38.0 (20.1, 49.5) |
B | 28.7 (20.6, 38.6) | 34.6 (26.9, 59.3) | 26.4 (17.4, 33.8) | 24.6 (19.7, 49.7) | |
CRP, mg/L | A | 0.5 (0.5, 0.5) | 0.5 (0.5, 1.0) | 0.5 (0.5, 2.0) | 0.5 (0.5, 0.5) |
B | 0.5 (0.5, 2.0) | 0.5 (0.5, 3.0) | 0.5 (0.5, 1.0) | 0.5 (0.5, 2.0) | |
Crohn’s Disease Participants | (N = 24) | (N = 24) | (N = 24) | (N = 24) | |
EPA, µg/mL | A | 30.6 (26.1, 38.2) | 57.0 (44.1, 60.3) | 40.1 (31.5, 46.3) | 69.4 (58.2, 94.0) |
B | 20.3 (17.9, 35.7) | 55.7 (34.4, 68.5) | 29.1 (14.8, 36.2) | 54.7 (26.0, 69.5) | |
DPA, µg/g | A | 15.7 (14.2, 22.4) | 20.7 (14.9, 27.2) | 19.9 (14.5, 22.9) | 22.6 (16.8, 29.8) |
B | 14.1 (11.9, 18.4) | 16.8 (14.7, 23.8) | 13.1 (11.1, 21.3) | 16.6 (14.2, 21.8) | |
DHA, µg/g | A | 55.1 (38.6, 69.8) | 63.6 (55.2, 76.2) | 59.5 (57.8, 77.3) | 80.8 (71.3, 88.8) |
B | 51.2 (38.7, 55.8) | 71.8 (56.7, 89.7) | 50.1 (36.5, 64.3) | 56.8 (43.8, 75.8) | |
Omega-3 index (EPA + DHA), µg/m Using serum measures | A | 83.5 (74.2, 107.9) | 114 (104, 149) | 104 (89.0, 119) | 146 (132, 184) |
B | 75.4 (54.0, 83.1) | 130 (95.0, 157) | 87.0 (57.2, 104) | 75.4 (54.0, 83.1) | |
Vitamin D -25(OH)D, nmol/L | A | 78.0 (73.0, 87.0) | 78.0 (74.0, 95.0) | 67.0 (58.0, 79.0) | 68.0 (60.0, 79.0) |
B | 87.0 (75.0, 94.0) | 85.0 (76.0, 94.0) | 70.0 (60.0, 77.0) | 63.0 (51.0, 69.0) | |
Calprotectin, µg/g | A | 108 (77.3, 219) | 120 (65.9, 823) | 458 (140, 722) | 116 (65.4, 179) |
B | 147 (81.7, 189) | 235 (68.8, 414) | 140 (48.3, 333) | 121 (53.3, 709) | |
CRP, mg/L | A | 2.0 (0.9, 3.5) | 1.2 (0.6, 4.5) | 1.4 (0.9, 4.2) | 1.3 (1.1, 4.8) |
B | 1.2 (0.5, 3.8) | 2.2 (0.5, 6.1) | 0.8 (0.5, 4.1) | 1.9 (0.5, 4.6) |
Outcome Measure | Treatment Effect; LO vs. Placebo | Period Effect; Period 2 vs. Period 1 | Carry-Over Effect * | |||
---|---|---|---|---|---|---|
Marginal Mean Difference (95% CI) | p-Value | Marginal Mean Difference (95% CI) | p-value | Treatment-by-Period Interaction (95% CI) | p-Value | |
Healthy Participants, N = 29 ** | ||||||
EPA, µg/mL | 47.0 (35.8, 58.3) | <0.001 | −2.19 (−12.6, 8.18) | 0.68 | 0.75 (0.55, 1.01) | 0.06 |
DPA, µg/mL | 4.36 (3.17, 5.55) | <0.001 | 0.22 (−0.90, 1.33) | 0.71 | 0.89 (0.70, 1.13) | 0.34 |
DHA, µg/mL | 22.0 (16.0, 28.0) | <0.001 | 0.15 (−6.01, 6.32) | 0.96 | 0.82 (0.67, 1.02) | 0.07 |
Omega-3 index, µg/mL + | 67.8 (52.8, 82.8) | <0.001 | −2.42 (−17.6, 12.7) | 0.75 | 0.81 (0.65, 1.00) | 0.05 |
Vitamin D -25(OH)D, nmol/L | 10.0 (6.34, 13.7) | <0.001 | −10.7 (−14.3, −7.01) | <0.001 | 1.08 (0.94, 1.24) | 0.27 |
Calprotectin, µg/g | 9.83 (−3.33, 23.0) | 0.14 | 3.65 (−9.83, 17.1) | 0.6 | 0.99 (0.40, 2.47) | 0.99 |
Crohn’s Disease Participants, N = 24 *** | ||||||
EPA, µg/mL | 19.3 (9.26, 29.4) | <0.001 | 0.54 (−9.47, 10.6) | 0.92 | 1.06 (0.48, 2.34) | 0.89 |
DPA, µg/mL | 2.18 (0.66, 3.70) | 0.005 | 0.29 (−1.22, 1.80) | 0.70 | 0.99 (0.70, 1.39) | 0.93 |
DHA, µg/mL | 14.2 (4.04, 24.3) | 0.006 | −3.10 (−13.3, 7.14) | 0.55 | 0.82 (0.54, 1.24) | 0.34 |
Omega-3 index, µg/mL | 33.0 (13.7, 52.3) | 0.001 | −2.66 (−22.1, 16.8) | 0.79 | 0.90 (0.49, 1.63) | 0.72 |
Vitamin D -25(OH)D, nmol/L | 4.69 (0.53, 8.86) | 0.03 | −20.5 (−24.7, −16.2) | <0.001 | 1.23 (1.05, 1.44) | 0.01 |
Calprotectin, µg/g | −96.9 (−570, 376) | 0.67 | 40.2 (−423, 503) | 0.87 | 0.27 (0.06, 1.26) | 0.09 |
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Brennan Laing, B.; Cavadino, A.; Ellett, S.; Ferguson, L.R. Effects of an Omega-3 and Vitamin D Supplement on Fatty Acids and Vitamin D Serum Levels in Double-Blinded, Randomized, Controlled Trials in Healthy and Crohn’s Disease Populations. Nutrients 2020, 12, 1139. https://doi.org/10.3390/nu12041139
Brennan Laing B, Cavadino A, Ellett S, Ferguson LR. Effects of an Omega-3 and Vitamin D Supplement on Fatty Acids and Vitamin D Serum Levels in Double-Blinded, Randomized, Controlled Trials in Healthy and Crohn’s Disease Populations. Nutrients. 2020; 12(4):1139. https://doi.org/10.3390/nu12041139
Chicago/Turabian StyleBrennan Laing, Bobbi, Alana Cavadino, Stephanie Ellett, and Lynnette R. Ferguson. 2020. "Effects of an Omega-3 and Vitamin D Supplement on Fatty Acids and Vitamin D Serum Levels in Double-Blinded, Randomized, Controlled Trials in Healthy and Crohn’s Disease Populations" Nutrients 12, no. 4: 1139. https://doi.org/10.3390/nu12041139