Oral ω-3 PUFA supplementation modulates inflammation in adipose tissue depots in morbidly obese women: A randomized trial

Nathalie Bakker; Meave Hickey; Rebecca Shams; Cristobal F Rivera; John Vlahos; Huib A Cense; Ahmet Demirkiran; Bhama Ramkhelawon; Alexander Pj Houdijk

doi:10.1016/j.nut.2023.112055

Oral ω-3 PUFA supplementation modulates inflammation in adipose tissue depots in morbidly obese women: A randomized trial

Nutrition. 2023 Jul:111:112055. doi: 10.1016/j.nut.2023.112055. Epub 2023 Apr 9.

Authors

Nathalie Bakker¹, Meave Hickey², Rebecca Shams², Cristobal F Rivera², John Vlahos², Huib A Cense³, Ahmet Demirkiran³, Bhama Ramkhelawon², Alexander Pj Houdijk⁴

Affiliations

¹ Northwest Clinics, Department of Surgery, Alkmaar, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Surgery, Amsterdam, The Netherlands; Red Cross Hospital, Department of Surgery, Beverwijk, The Netherlands.
² Division of Vascular and Endovascular Surgery, Department of Surgery and Cell Biology, New York University Langone Medical Center, New York, New York, United States.
³ Red Cross Hospital, Department of Surgery, Beverwijk, The Netherlands.
⁴ Northwest Clinics, Department of Surgery, Alkmaar, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Surgery, Amsterdam, The Netherlands; Red Cross Hospital, Department of Surgery, Beverwijk, The Netherlands. Electronic address: A.P.J.houdijk@nwz.nl.

PMID: 37182400
DOI: 10.1016/j.nut.2023.112055

Abstract

Objectives: Obesity is characterized by local and systemic low-grade inflammatory responses. Adipose tissue macrophages (ATM) play decisive roles in inflammation, insulin signaling, and various metabolic dysfunctions. Diets enriched with ω-3 polyunsaturated fatty acids (PUFAs) have been shown to improve health and mitigate pathologic conditions. However, the effects of ω-3 PUFA on adipose tissue inflammation, ATM number, and phenotype are poorly defined in human obesity. The aim of this study was to examine differences in expression of metabolic-inflammatory markers in omental, mesenteric, and subcutaneous fat depots of obese women supplemented with ω-3 PUFAs for 4 wk compared with a low-calorie diet before bariatric surgery.

Methods: In a randomized controlled trial, inflammatory markers in the abdominal adipose tissue and the systemic response in obese women were studied. Patients were treated with a 2-wk low-calorie diet (LCD) or a 4-wk ω-3 PUFA-enriched diet (920 mg eicosapentaenoic acid, 760 mg docosahexaenoic acid daily) before laparoscopic bypass surgery. Omental, mesenteric, and subcutaneous adipose tissue biopsies were collected during surgery and analyzed for quantity and phenotype of ATMs, and profiled for adipokines, cytokines, and signal transduction molecules.

Results: The chronic inflammatory state characterized by ATM markers was mostly improved by ω-3 PUFAs in visceral adipose tissue. We observed a decreased expression of CD45, CCL2, and CD68, indicating a lower inflammatory state. In patients with type 2 diabetes, ω-3 PUFAs lowered the expression of Netrin-1.

Conclusions: Compared with an LCD, a diet enriched with ω-3 PUFAs influences the inflammatory state in different adipose tissue depots, by affecting markers of adipose tissue inflammation, macrophage phenotype, and retention. However, this was not reflected in clinical parameters such as insulin resistance and inflammatory cytokines. Subcutaneous adipose tissue and visceral adipose tissue have different responses to an LCD or a ω-3 PUFA-enriched diet. The presence of diabetes modifies the expression of inflammatory markers.

Keywords: Adipose tissue; Inflammation; Morbid obesity; ω-3 fatty acids.

Publication types

Randomized Controlled Trial

MeSH terms

Adipose Tissue / metabolism
Cytokines / metabolism
Diabetes Mellitus, Type 2* / drug therapy
Dietary Supplements
Fatty Acids, Omega-3* / pharmacology
Fatty Acids, Omega-3* / therapeutic use
Female
Humans
Inflammation / metabolism
Obesity, Morbid* / surgery

Substances

Fatty Acids, Omega-3
Cytokines