Effects of n-3 fatty acids and exercise on oxidative stress parameters in type 2 diabetic: a randomized clinical trial

Ana Paula Trussardi Fayh, Katiuce Borges, Giovani Santos Cunha, Mauricio Krause, Ricardo Rocha, Paulo Ivo Homem de Bittencourt Jr, José Cláudio Fonseca Moreira, Rogério Friedman, Juliane da Silva Rossato, Jõao Roberto Fernandes, Alvaro Reischak-Oliveira, Ana Paula Trussardi Fayh, Katiuce Borges, Giovani Santos Cunha, Mauricio Krause, Ricardo Rocha, Paulo Ivo Homem de Bittencourt Jr, José Cláudio Fonseca Moreira, Rogério Friedman, Juliane da Silva Rossato, Jõao Roberto Fernandes, Alvaro Reischak-Oliveira

Abstract

Background: The relationship between diabetes and oxidative stress has been previously reported. Exercise represents a useful non-pharmacological strategy for the treatment in type 2 diabetic (T2DM) patients, but high intensity exercise can induce a transient inflammatory state and increase oxidative stress. Nutritional strategies that may contribute to the reduction of oxidative stress induced by acute exercise are necessary. The aim of this study was to examine if n-3 PUFA supplementation intervention can attenuate the inflammatory response and oxidative stress associated with high intensity exercise in this population. As a primary outcome, lipoperoxidation measurements (TBARS and F2-isoprostanes) were selected.

Methods: Thirty T2DM patients, without chronic complications, were randomly allocated into two groups: placebo (gelatin capsules) or n-3 PUFA (capsules containing 180 mg of eicosapentaenoic acid and 120 mg of docosahexaenoic acid). Blood samples were collected fasting before and after 8 weeks supplementation. In the beginning and at the end of protocol, an acute exercise was performed (treadmill), and new blood samples were collected before and immediately after the exercise for measurements of oxidative stress and high-sensitivity C-reactive protein (hs-CRP).

Results: After the supplementation period, a decrease in triglycerides levels was observed only in n-3 PUFA supplementation group (mean difference and 95% CI of 0.002 (0.000-0.004), p = 0.005). Supplementation also significantly reduced TRAP levels after exercise (mean difference and 95% CI to 9641 (- 20,068-39,351) for - 33,884 (- 56,976 - -10,793), p = 0.004, Cohen's d effect size = 1.12), but no significant difference was observed in n-3 PUFA supplementation group in lipoperoxidation parameters as TBARS (mean difference and 95% CI to - 3.8 (- 10-2.4) for - 2.9 (- 1.6-7.4) or F2-isoprostanes (mean difference and 95% CI -0.05 (- 0.19-0.10) for - 0.02 (- 0.19-0.16), p > 0.05 for both.

Conclusion: PUFA n-3 supplementation reduced triglycerides as well as TRAP levels after exercise, without a significant effect on inflammatory and oxidative stress markers.This study is registered at ClinicalTrials.gov with the registration number of NCT03182712.

Keywords: Acute exercise; Inflammation; Omega-3; Oxidative stress; Type 2 diabetes.

Conflict of interest statement

This study was approved by the HCPA Ethics and Research Committee (06–222). The study was conducted in accordance with the requirements of the declarations of Helsinki. All participants were informed about the procedures and signed an informed consent form prior to enrollment in the study.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flowchart of experimental sessions
Fig. 2
Fig. 2
Flow diagram of patient recruitment and randomization

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