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2023, Número 6

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Acta Pediatr Mex 2023; 44 (6)


Ácidos grasos omega-3/omega-6: efectos en el crecimiento y neurodesarrollo del feto y del recién recién nacido prematuro. Una revisión narrativa

Perrotta G

Idioma: Ingles.
Referencias bibliográficas: 46
Paginas: 461-473
Archivo PDF: 256.34 Kb.


RESUMEN

Antecedentes: Los ácidos grasos omega-3/omega-6 se prescriben durante el embarazo, la lactancia y en paciente con parto prematuro. En las últimas décadas se ha intentado averiguar si la indicación de omega-3/omega-6 tiene efectos en el crecimiento y el neurodesarrollo en humanos.
Materiales y Métodos: Se revisaron artículos originales relacionados con omega-3/ omega-6, crecimiento y nutrición en humanos, en pacientes atendidos en los servicios de Ginecología y Pediatría. La revisión de artículos se llevó a cabo en la base de datos de PubMed, desde enero de 1979 hasta marzo de 2023.
Resultados: Se encontraron 44 artículos relacionados con el tema. Surgieron importantes cuestiones críticas respecto a los estudios publicados, a pesar de la evidencia alentadora de la utilidad de los omega-3/omega-6 durante el embarazo, la lactancia, los estados de desnutrición y los procesos inflamatorios, mientras que los datos de la eficacia en el feto, neonatal, y los pacientes pediátricos son conflictivos. En los estudios surgen preguntas estructurales y funcionales que pueden poner en duda la validez de los resultados.
Conclusiones: Los datos son alentadores y sugieren que ciertos aspectos respecto al tipo de administración y dosis de suplementación con ácidos grasos omega-3/omega- 6 deben investigarse a mayor detalle para demostrar la validez clínica de dichas prescripciones, especialmente en términos de maduración gestacional, crecimiento y nutrición humana en la práctica clínica en Ginecología y Pediatría.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Nelson DL, Cox MM. Principles of Biochemistry. SeventhEdition. Lehninger Pub. 2017.

  2. Simopoulos AP. The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomed Pharmacother 2002;56 (8): 365-79. DOI: 10.1016/s0753-3322(02)00253-6.

  3. Miles EA, Childs CE, Calder PC. Long-Chain PolyunsaturatedFatty Acids (LCPUFAs) and the Developing Immune System:A Narrative Review. Nutrients 2021; 13: 247. DOI: 10.3390/nu13010247.

  4. Lehner A, Staub K, Aldakak L, Eppenberger P, et al. Impact ofomega-3 fatty acid DHA and EPA supplementation in pregnantor breast-feeding women on cognitive performanceof children: systematic review and meta-analysis. In NutrRev 2021; 79 (5): 585-598. DOI: 10.1093/nutrit/nuaa060.

  5. Aparicio E, Martin-Grau C, Bedmar C, Serrat-Orus N, et al.Maternal Factors Associated with Levels of Fatty Acids,Specifically n-3 PUFA during Pregnancy: ECLIPSES Study.Nutrients 2021; 13 (2): 317. DOI: 10.3390/nu13020317.

  6. Brainard JS, Jimoh OF, Deane KH, Biswa P, et al. Omega-3,Omega-6, and Polyunsaturated Fat for Cognition: SystematicReview and Meta-analysis of Randomized Trials.J Am Med Dir Assoc 2020; 21 (10): 1439-1450.e21. DOI:10.1016/j.jamda.2020.02.022.

  7. Schwingshackl L, Hoffmann G. Monounsaturated fattyacids, olive oil and health status: a systematic review andmeta-analysis of cohort studies. Lipids Health Dis 2014;13: 154. DOI: 10.1186/1476-511X-13-154.

  8. Yang S, Lin R, Si L, Jian W, et al. Cod-Liver Oil ImprovesMetabolic Indices and hs-CRP Levels in GestationalDiabetes Mellitus Patients: A Double-Blind RandomizedControlled Trial. J Diabetes Res 2019; 7074042. DOI:10.1155/2019/7074042.

  9. West AL, Miles EA, Lillycrop KA, Han L, et al. Postprandialincorporation of EPA and DHA from transgenic Camelinasativa oil into blood lipids is equivalent to that from fish oilin healthy humans. Br J Nutr 2019; 121 (11): 1235-1246.DOI: 10.1017/S0007114519000825.

  10. Schwab US, Lankinen MA, de Mello VD, Manninen SM,et al. Camelina Sativa Oil, but not Fatty Fish or Lean Fish,Improves Serum Lipid Profile in Subjects with ImpairedGlucose Metabolism-A Randomized Controlled Trial. MolNutr Food Res 2018; 62 (4). DOI: 10.1002/mnfr.201701042.

  11. McNamara RK, Kalt W, Shidler MD, McDonald J, et al.Cognitive response to fish oil, blueberry, and combinedsupplementation in older adults with subjective cognitiveimpairment. Neurobiol Aging 2018; 64: 147-156. DOI:10.1080/1028415X.2017.1287833.

  12. Dawczynski C, Dittrich M, Neumann T, Goetze K, et al.Docosahexaenoic acid in the treatment of rheumatoidarthritis: A double-blind, placebo-controlled, randomizedcross-over study with microalgae vs. sunflower oil. Clin Nutr2018; 37 (2): 494-504. DOI: 10.1016/j.clnu.2017.02.021.

  13. Liu H, Wang F, Liu X, Xie Y, et al. Effects of marine-derivedand plant-derived omega-3 polyunsaturated fatty acidson erythrocyte fatty acid composition in type 2 diabeticpatients. Lipids Health Dis 2022; 21 (1): 20. DOI: 10.1186/s12944-022-01630-0.

  14. Fisk HL, Childs CE, Miles EA, Ayres R, et al. Modificationof subcutaneous white adipose tissue inflammation byomega-3 fatty acids is limited in human obesity-a doubleblind, randomised clinical trial. EBioMedicine 2022; 77:103909. DOI: 10.1016/j.ebiom.2022.103909.

  15. Jackson PA, Husberg C, Calder PC, Khan J, et al. Diurnalrhythm of plasma EPA and DHA in healthy adults. ProstaglandinsLeukot Essent Fatty Acids 2020; 154: 102054. DOI:10.1016/j.plefa.2020.102054.

  16. Chevalier L, Vachon A, Plourde M. Pharmacokinetics ofSupplemental Omega-3 Fatty Acids Esterified in Monoglycerides,Ethyl Esters, or Triglycerides in Adults in a RandomizedCrossover Trial. J Nutr 2021; 151 (5): 1111-1118. DOI:10.1093/jn/nxaa458.

  17. Ivanisevic M, Horvaticek M, Delmis K, Delmis J. Supplementationof EPA and DHA in pregnant women with type1 diabetes mellitus. Ann Med 2021; 53 (1): 848-859. DOI:10.1080/07853890.2021.1936151.

  18. Monthé-Dréze C, Sen S, Hauguel-de Monzon S, CatalanoPM. Effect of Omega-3 Supplementation in PregnantWomen with Obesity on Newborn Body Composition,Growth and Length of Gestation: A Randomized ControlledPilot Study. Nutrients 2021; 13 (2): 578. DOI: 10.3390/nu13020578.

  19. Angoa G, Pronovost E, Ndiaye ABKT, Levoie PM, et al. Effectof Maternal Docosahexaenoic Acid Supplementationon Very Preterm Infant Growth: Secondary Outcome ofa Randomized Clinical Trial. Neonatology 2022; 119 (3):377-385. DOI: 10.1159/000524147.

  20. Carlson SE, Colombo J, Gajewski BJ, Gustafson KM, et al.DHA supplementation and pregnancy outcomes. Am J ClinNutr 2013; 97 (4): 808-15. DOI: 10.3945/ajcn.112.050021.

  21. Ingol TT, Li R, Boone KM, Rausch J, et al. Docosahexaenoicand Arachidonic Acid Supplementation of Toddlers BornPreterm Does Not Affect Short-Term Growth or Adiposity.J Nutr 2019; 149 (12): 2182-2190. DOI: 10.1093/jn/nxz115.

  22. Sun L, Li Y, Xie W. Association between omega-3 fatty acidsupplementation and lower risk of preterm delivery: asystematic review and meta-analysis. J Matern Fetal NeonatalMed 2022; 35 (12): 2294-2303. DOI: 10.1001/2012.jama.11374.

  23. Simmonds LA, Yelland LN, Best KP, Liu G, et al. Translatingn-3 polyunsaturated fatty acid status from whole blood toplasma and red blood cells during pregnancy: Translatingn-3 status across blood fractions in pregnancy. ProstaglandinsLeukot Essent Fatty Acid 2022; 176: 102367. DOI:10.1016/j.plefa.2021. 102367.

  24. Middleton P, Gomersall JC, Gould JF, Shepherd E, etal. Omega-3 fatty acid addition during pregnancy. CochraneDatabase Syst Rev 2018; 11 (11): CD003402. DOI:10.1002/14651858.CD003402.pub3.

  25. Lager S, Ramirez VI, Acosta O, Meireles C, et al. DocosahexaenoicAcid Supplementation in Pregnancy ModulatesPlacental Cellular Signaling and Nutrient Transport Capacityin Obese Women. J Clin Endocrinol Metabol 2017; 102 (12):4557-4567. DOI: 10.1210/jc.2017-01384.

  26. Khandelwal S, Kondal D, Chaudhry M, Patil K, et al. Effectof Maternal Docosahexaenoic Acid (DHA) Supplementationon Offspring Neurodevelopment at 12 Months in India: ARandomized Controlled Trial. Nutrients 2020; 12: 3041.DOI: 10.3390/nu12103041.

  27. Rajarethnem HT, Bhat KMR, JC M, Kumar G, et al. CombinedSupplementation of Choline and DocosahexaenoicAcid during Pregnancy Enhances Neurodevelopment ofFetal Hippocampus. Neurol Res Int 2017; 8748706. DOI:10.1155/2017/8748706.

  28. von Schacky C. Omega-3 Fatty Acids in Pregnancy—TheCase for a Target Omega-3 Index. Nutrients 2020; 12: 898.DOI: 10.3390/nu12040898.

  29. Mulder KA, Elango R, Innis SM. Fetal DHA inadequacyand the impact on child neurodevelopment: a follow-upof a randomised trial of maternal DHA supplementationin pregnancy. Br J Nutr 2018; 1-9. DOI: 10.1017/S0007114517003531.

  30. Jiang T, Liu B, Dong X, Lin M, Zhang M, et al. Associationbetween sn-2 fatty acid profiles of breast milk and developmentof the infant intestinal microbiome. Food Funct 2018;9 (2): 1028-1037. DOI: 10.1039/c7fo00088j.

  31. van Good SA, Dijck-Brouwer DA, Doornbos B, ErwichJJHM, et al. Supplementation of DHA but not DHA witharachidonic acid during pregnancy and lactation influencesgeneral movement quality in 12-week-old terminfants. Br J Nutr 2010; 103: 235-242. DOI: 10.1017/S0007114509991528.

  32. Shulkin M, Pimpin L, Bellinger D, Kranz S, et al. n-3 FattyAcid Supplementation in Mothers, Preterm Infants, andTerm Infants and Childhood Psychomotor and Visual Development:A Systematic Review and Meta-Analysis. J Nutr2018; 148 (3): 409-418. DOI: 10.1093/jn/nxx031.

  33. Hewawasam E, Collins CT, Muhlhausler BS, Yelland LN,et al. DHA supplementation in infants born preterm andthe effect on attention at 18 months' corrected age:follow-up of a subset of the N3RO randomised controlledtrial. Br J Nutr 2021; 125 (4): 420-431. DOI: 10.1017/S0007114520002500.

  34. Gawlik NR, Makrides M, Kettler L, Yelland LN, et al. Theinfluence of DHA supplementation duringon language development across childhood: Follow-upof a randomised controlled trial. Prostaglandins LeukotEssent Fatty Acids 2020; 163: 102207. DOI: 10.1016/j.plefa.2020.102207.

  35. Hellstrom A, Nilsson AK, Wackernagel D, Pivodic A, et al.Effect of Enteral Lipid Supplement on Severe Retinopathyof Prematurity: A Randomized Clinical Trial. JAMA Pediatr2021; 175 (4): 359-367. DOI: 10.1001/jamapediatrics.2020.5653.

  36. Bernabe-García M, Calder PC, Villegas-Silva R, Rodríuez-Cruz M, et al. Efficacy of Docosahexaenoic Acid for thePrevention of Necrotizing Enterocolitis in Preterm Infants:A Randomized Clinical Trial. Nutrients 2021; 13 (2): 648.DOI: 10.3390/nu13020648.

  37. Gunaratne AW, Makrides M, Collins CT, Gibson RA, etal. Docosahexaenoic acid supplementation of preterminfants and parent-reported symptoms of allergic diseaseat 7 years corrected age: follow-up of a randomized controlledtrial. Am J Clin Nutr 2019; 109 (6): 1600-1610. DOI:10.1093/ajcn/nqz010.

  38. Marc I, Piedboeuf B, Fraser W, Masse B, et al. Effect ofMaternal Docosahexaenoic Acid Supplementation onBronchopulmonary Dysplasia-Free Survival in BreastfedPreterm Infants: A Randomized Clinical Trial. JAMA 2020;324 (2): 157-167. DOI: 10.1001/jama.2020.8896.

  39. Hsiao CC, Lin HC, Chang YJ, Yang SP, et al. Intravenous fishoil containing lipid emulsion attenuates inflammatory cytokinesand the development of bronchopulmonary dysplasiain very premature infants: A double-blind, randomizedcontrolled trial. Clin Nutr 2019; 38 (3): 1045-1052. DOI:10.1016/j.clnu.2018.06.929.

  40. Khairani S, Fauziah N, Wiraswati HL, Panigoro R, et al. ThePotential use of a Curcumin-Piperine Combination as anAntimalarial Agent: A Systematic Review. J Trop Med 2021;2021: 9135617. DOI: 10.1155/2021/9135617.

  41. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, et al. ThePRISMA 2020 statement: An updated guideline for reportingsystematic reviews. BMJ 2021; 372 (71). DOI: 10.1136/bmj.n71.

  42. Tomaszewski N, He X, Solomon V, Lee M, et al. Effect ofAPOE Genotype on Plasma Docosahexaenoic Acid (DHA),Eicosapentaenoic Acid, Arachidonic Acid, and HippocampalVolume in the Alzheimer's Disease Cooperative Study-Sponsored DHA Clinical Trial. J Alzheimers Dis 2020; 74(3): 975-990. DOI: 10.3233/JAD-191017.

  43. Chen X, Wu Y, Zhang Z, Zheng X, et al. Effects of thers3834458 Single Nucleotide Polymorphism in FADS2 onLevels of n-3 Long-chain Polyunsaturated Fatty Acids: AMeta-analysis. Prostaglandins Leukot Essent Fatty Acids2019; 150: 1-6. DOI: 10.1016/j.plefa.2019.08.005.

  44. Scholtz SA, Kerling EH, Shaddy DJ, Thodosoff JM, et al.Docosahexaenoic acid (DHA) supplementation in pregnancydifferentially modulates arachidonic acid and DHAstatus across FADS genotypes in pregnancy. ProstaglandinsLeukot Essent Fatty Acids 2015; 94: 29-33. DOI: 10.1016/j.plefa.2014.10.008.

  45. Biagetti C, Correani A, D’Ascenzo R, Ferretti E, et al. Isintravenous fish oil associated with the neurodevelopmentof extremely low birth weight preterm infants onparenteral nutrition? Clin Nutr 2021; 40 (5): 2845-2850.DOI: 10.1016/j.clnu.2021.02.036.

  46. Biagetti C, Correani A, D’Ascenzo R, Bellagamba MP, et al.Does intravenous fish oil affect the growth of extremelylow birth weight preterm infants on parenteral nutrition?Clin Nutr 2019; 38 (5): 2319-2324. DOI: 10.1016/j.clnu.2018.10.009




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