ࡱ > T V S R %H bjbj 8P + L 9 M l r H $ { " J i F F F A F F F 7
W 0 g" g" g" T F F F F F F F F F F F F F F g" F F F F F F F F F : P r o t o c o l f o r m e t a - a n a l y s i s t o a s s e s s t h e e f f e c t o f m a r i n e - d e r i v e d n - 3 p o l y u n s a t u r a t e d f a t t y a c i d s o n C R P , I L - 6 a n d T N F -
O b j e c t i v e
T o s y s t e m a t i c a l l y e v a l u a t e t h e e f f e c t o f m a r i n e - d e r i v e d n - 3 P U F A s f r o m s u p p l e m e n t a t i o n o r d i e t a r y i n t a k e o n f a s t i n g b l o o d l e v e l s o f C R P , I L - 6 a n d T N F - i n s u b j e c t s w i t h c h r o n i c d i s e a s e a n d h e a l t h y s u b j e c t s .
I n c l u s i o n C r i t e r i a
1 . H a v i n g a r a n d o m i z e d p l a c e b o c o n t r o l l e d d e s i g n ;
2 . R e p o r t e d d a t a o n f a s t i n g b l o o d l e v e l s o f T N F - , I L - 6 , o r C R P ;
3 . H a v i n g a d r o p - o u t r a t e l e s s t h a n 30%;
4. Recruited subjects with chronic disease (chronic autoimmune or non-autoimmune disease) or healthy subjects.
Searching Methods
The following database will be searched: Web of Science, PubMed, Embase and Medline. Hand-searching of the bibliographic sections of all relevant articles and recent reviews was also undertaken. Following Medical Subject Headings terms or key words were searched:
#1: n-3 polyunsaturated fatty acid OR omega-3 polyunsaturated fatty acid OR - 3 f a t t y a c i d O R o m e g a - 3 f a t t y a c i d O R p o l y u n s a t u r a t e d f a t t y a c i d O R e i c o s a p e n t a e n o i c a c i d O R d o c o s a h e x a e n o i c a c i d O R f i s h o i l
# 2 : i n t e r l e u k i n 6 O R i n t e r l e u k i n O R t u m o r n e c r o s i s f a c t o r O R t u m o r n e c r o s i s f a c t o r a l p h a O R T N F - O R c y t o k ine OR C-reactive protein OR CRP OR inflammation
#1 AND #2
The search was restricted to studies published in any language from 1950 to 2013.
Data Extraction and Quality Assessment
Study selection and data extraction will be undertaken independently by two investigators, with discrepancies resolved by consensus. The data collected includes the first authors name, year of publication, sample size, age, BMI sex ratio (male/total subjects) and healthy status of subjects, intervention methods, study desi g n ( p a r a l l e l - g r o u p , c r o s s o v e r o r f a c t o r i a l ) , d a i l y d o s e o f n - 3 P U F A s , d u r a t i o n o f f o l l o w - u p , a n d d a t a o f f a s t i n g b l o o d l e v e l o f T N F - , I L - 6 a n d C R P .
C o c h r a n e c r i t e r i a w i l l b e u s e d t o a s s e s s t h e q u a l i t y o f s t u d i e s i n c l u d e d i n t h e p r e s e n t m e t a - a n a l y s i s , i n c luding sequence generation, allocation concealment, blinding of participants, personnel and outcome assessors, incomplete outcome data and selective outcome reporting ADDIN EN.CITE Higgins201151[1]515117Higgins, J.P.T.Green, SCochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.orgThe Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org2011[ HYPERLINK \l "_ENREF_1" \o "Higgins, 2011 #51" 1].
Meta-analysis
Studies recruiting subjects with chronic autoimmune disease, studies recruiting subjects with chronic non-autoimmune disease and studies recruiting healthy subjects will be included into different meta-analyses. In addition, We will also separate studies using n-3 polyunsaturated fatty acids from supplementation (seafood oils or highly purified n-3 polyunsaturated fatty acids) as active treatment with studies using n-3 polyunsaturated fatty acids from dietary intake (fish intake), and included them into different meta-analyses.
Weighted mean difference will be used as the effect size. A random-effect model will be used to pool study-specific effect sizes, and a P value < 0.05 is considered to be statistically significant. Heterogeneity will be assessed using the chi-square method. I2 > 50% indicated significant heterogeneity ADDIN EN.CITE Hooper201255[2]555517Hooper, L.Summerbell, C. D.Thompson, R.Sills, D.Roberts, F. G.Moore, H. J.Davey Smith, G.Norwich Medical School, University of East Anglia, Norwich, UK. l.hooper@uea.ac.uk.Reduced or modified dietary fat for preventing cardiovascular diseaseCochrane Database Syst RevCochrane Database Syst RevCD00213752012/05/18AdultAgedCardiovascular Diseases/epidemiology/*prevention & controlCholesterol/bloodDiet, Fat-Restricted/*methodsDietary Fats/*administration & dosageFats, Unsaturated/administration & dosageHumansMiddle AgedRandomized Controlled Trials as TopicRisk FactorsTriglycerides/blood20121469-493X (Electronic)
1361-6137 (Linking)22592684Meta-Analysis
Research Support, Non-U.S. Gov't
Reviewhttp://www.ncbi.nlm.nih.gov/pubmed/2259268410.1002/14651858.CD002137.pub3eng[ HYPERLINK \l "_ENREF_2" \o "Hooper, 2012 #55" 2]. Subgroup analysis will be undertaken to explore the sources of heterogeneity and their influence on effect size according to the difference in study design, placebo, duration, daily dose of n-3 PUFAs, and age, sex ratio (male/total subjects) and body mass index (BMI) of subjects; the cut-off points for duration, daily dose and age are their medians; 0.5 is used as the cut-off point for sex ratio; 30 kg/m2 is used as the cut-off points for BMI. For meta-analysis in subjects with chronic diseases, subgroup analysis will also be conducted according to difference in types of diseases. Meta-regression will be conducted to explore whether subgroup difference is significant, and whether there is significant linear relationship (P for coefficient < 0.05) between effect size and continuous confounding variables (duration, daily dose, age, sex ratio and BMI); the adjusted R2 indicated the percentage of between-study heterogeneity that can be explained by the confounding variables. If two or more confounding factors show significant influence on the effect size (P for subgroup difference or coefficient < 0.05), a joint test will be conducted to explain heterogeneity caused by these confounding factors by including them into a single meta-regression model simultaneously ADDIN EN.CITE Harbord2008402[3]40240217Harbord, Roger MHiggins, Julian PTMeta-regression in StataMetaMeta493-519842008[ HYPERLINK \l "_ENREF_3" \o "Harbord, 2008 #402" 3]; the adjusted R2 of the overall model indicates the percentage of between-study heterogeneity that can be explained by these confounding factors ADDIN EN.CITE Harbord2008402[3]40240217Harbord, Roger MHiggins, Julian PTMeta-regression in StataMetaMeta493-519842008[ HYPERLINK \l "_ENREF_3" \o "Harbord, 2008 #402" 3]. If no significant linear relationship is observed between effect size and continuous confounding variables, restricted cubic spline analysis will be used to test potential cubic relationship between them (3 knots) ADDIN EN.CITE Zheng2013401[4]40140117Zheng, Ju-ShengHu, Xiao-JieZhao, Yi-MinYang, JingLi, DuoIntake of fish and marine n-3 polyunsaturated fatty acids and risk of breast cancer: meta-analysis of data from 21 independent prospective cohort studiesBMJ: British Medical JournalBMJ: British Medical Journal34620131756-1833[ HYPERLINK \l "_ENREF_4" \o "Zheng, 2013 #401" 4]. We will also conduct sensitivity analysis to
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