Arthritis und Rheuma 2015; 35(04): 233-237
DOI: 10.1055/s-0037-1618376
Osteologie
Schattauer GmbH

Mehrfach ungesättigte Omega-3-Fettsäuren und Knochen-gesundheit

Long-chain n-3 polyunsaturated fatty acids and bone health
T. Schmidt
1   Klinik und Poliklinik für Orthopädie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
2   Klinik für Orthopädie und orthopädische Rheumatologie, Klinikum Bad Bramstedt, Bad Bramstedt
,
W. Rüther
1   Klinik und Poliklinik für Orthopädie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
2   Klinik für Orthopädie und orthopädische Rheumatologie, Klinikum Bad Bramstedt, Bad Bramstedt
,
A. Niemeier
1   Klinik und Poliklinik für Orthopädie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
2   Klinik für Orthopädie und orthopädische Rheumatologie, Klinikum Bad Bramstedt, Bad Bramstedt
› Author Affiliations
Further Information

Publication History

Publication Date:
27 December 2017 (online)

Zusammenfassung

Der systemische Lipidstoffwechsel und der Knochenstoffwechsel stehen in komplexer Wechselwirkung miteinander. Vor diesem Hintergrund ist es verständlich, dass auch Nahrungslipide den Knochenstoffwechsel mittelbar und unmittelbar beeinflussen. Es gibt eine Vielzahl Studien jüngeren Datums, die sich speziell mit der Frage beschäftigen, ob und wie sich die Nahrungsaufnahme mehrfach ungesättigter Fettsäuren, insbesondere das nutritive Verhältnis von n-6-Fettsäuren zu n-3-Fettsäuren (n-6/n-3-Ratio), auf den Knochen auswirkt. Obwohl einige klinische Studien auf einen positiven Effekt eines niedrigen n-6/n-3-Verhältnisses in der Nah-rung hinweisen, bleiben die Effekte einzelner spezifischer Fettsäuren dabei unklar. Die wenigen kontrollierten, prospektiv randomisierten Studien zu der Thematik erlauben trotz vielversprechender Ergebnisse wegen der reduzierten Vergleichbarkeit der Studiendesigns noch keine allgemeinen Rückschlüsse. Es wäre verfrüht, eine allgemeine klinische Empfehlung auszusprechen, die aktuelle Datenlage gibt jedoch hinreichend Anlass, um weitere Studien zu der Thematik zu initiieren.

Summary

It has become increasingly clear in recent years that there are close functional ties between fatty acid metabolism and bone metabolism. A number of studies have investigated the influence of dietary polyunsaturated fatty acid intake, in particular of the n-6/n-3 fatty acid ratio, on bone traits. There is evidence for a beneficial effect of a lower dietary n-6/n-3 ratio, but effects of specific fatty acids have not been consistent. A few randomized controlled trials in humans also support a positive effect of n-3 fatty acids on bone, but the heterogeneity of the different study designs make it difficult to draw definitive conclusions that would support recommendations for clinical use. Despite these limitations, there appears to be sufficient evidence to merit further clinical trials.

 
  • Literatur

  • 1 Calder PC. Marine omega-3 fatty acids and inflammatory processes: Effects, mechanisms and clinical relevance. Biochim Biophys Acta 2015; 1851 469-484.
  • 2 Simopoulos AP. The importance of the ratio of omega-3/omega-6 essential fatty acids. Biomed Pharmacother 2002; 56 (08) 365-379.
  • 3 Janssen I C, Kiliaan AJ. Long-chain polyunsaturated fatty acids (LCPUFA) from genesis to senescence: the influence of LCPUFA on neural development, aging, and neurodegeneration. Prog Lipid Res 2014; 53: 1-17.
  • 4 Nestel P, Clifton P, Colquhoun D. et al. Indications for Omega-3 Long Chain Polyunsaturated Fatty Acid in the Prevention and Treatment of Cardiovascular Disease. Heart Lung Circ 2015; Apr 3. pii S1443 9506 (15) 00167-5. [Epub ahead of print]
  • 5 Miles EA, Calder PC. Influence of marine n-3 polyunsaturated fatty acids on immune function and a systematic review of their effects on clinical outcomes in rheumatoid arthritis. Br J Nutr 2012; 107 (Suppl. 02) Suppl S171-S184.
  • 6 Kruger MC, Coetzee M, Haag M, Weiler H. Long-chain polyunsaturated fatty acids: Selected mechanisms of action on bone. Prog Lipid Res 2010; 49: 438-449.
  • 7 Shen CL, Yeh JK, Rasty J. et al Protective effect of dietary long-chain n-3 polyunsaturated fatty acids on bone loss in gonad-intact middle-aged male rats. Br J Nutr 2006; 95: 462-468.
  • 8 Fallon EM, Nazarian A, Nehra D. et al The effect of docosahexaenoic acid on bone microstructure in young mice and bone fracture in neonates. J Surg Res 2014; 191: 148-155.
  • 9 Koren N, Simsa-Maziel S, Shahar R. et al Exposure to omega-3 fatty acids at early age accelerate bone growth and improve bone quality. J Nutr Biochem 2014; 25: 623-633.
  • 10 Lukas R, Gigliotti JC, Smith BJ. et al Consumption of different sources of omega-3 polyunsaturated fatty acids by growing female rats affects long bone mass and microarchitecture. Bone 2011; 49: 455-462.
  • 11 Raghu Nadhanan R, Skinner J, Chung R. et al Supplementation with fish oil and genistein, individually or in combination, protects bone against the adverse effects of methotrexate chemotherapy in rats. PLoS One 2013; 8: e71592
  • 12 Tarlton JF, Wilkins LJ, Toscano MJ. et al Reduced bone breakage and increased bone strength in free range laying hens fed omega-3 polyunsaturated fatty acid supplemented diets. Bone 2013; 52: 578-586.
  • 13 Kim Y, Kelly OJ, Ilich JZ. Synergism of alpha-linolenic acid, conjugated linoleic acid and calcium in decreasing adipocyte and increasing osteoblast cell growth. Lipids 2013; 48: 787-802.
  • 14 Orchard TS, Pan X, Cheek F. et al A systematic review of omega-3 fatty acids and osteoporosis. Br J Nutr 2012; 107 (Suppl. 02) Suppl S253-S260.
  • 15 Kajarabille N, Diaz-Castro J, Hijano S. et al A new insight to bone turnover: role of omega-3 polyunsaturated fatty acids. Sci World J 2013; 2013 589641
  • 16 Orchard TS, Cauley JA, Frank GC. et al Fatty acid consumption and risk of fracture in the Women’s Health Initiative. Am J Clin Nutr 2010; 92: 1452-1460.
  • 17 Farina EK, Kiel DP, Roubenoff R. et al Dietary Intakes of Arachidonic Acid and alpha-Linolenic Acid Are Associated with Reduced Risk of Hip Fracture in Older Adults. J Nutr 2011; 141: 1146-1153.
  • 18 Farina EK, Kiel DP, Roubenoff R. et al Protective effects of fish intake and interactive effects of long-chain polyunsaturated fatty acid intakes on hip bone mineral density in older adults: the Framingham Osteoporosis Study. Am J Clin Nutr 2011; 93: 1142-1151.
  • 19 Virtanen JK, Mozaffarian D, Cauley JA. et al Fish Consumption, Bone Mineral Density, and Risk of Hip Fracture Among Older Adults: The Cardiovascular Health Study. J Bone Mineral Res 2010; 25: 1972-1979.
  • 20 Virtanen JK, Mozaffarian D, Willett WC, Feskanich D. Dietary intake of polyunsaturated fatty acids and risk of hip fracture in men and women. Osteoporos Int 2012; 23: 2615-2624.
  • 21 Jarvinen R, Tuppurainen M, Erkkila AT. et al Associations of dietary polyunsaturated fatty acids with bone mineral density in elderly women. Eur J Clin Nutr 2012; 66: 496-503.
  • 22 Martinez-Ramirez MJ, Palma S, Martinez-Gonzalez MA. et al Dietary fat intake and the risk of osteoporotic fractures in the elderly. Eur J Clin Nutr 2007; 61: 1114-1120.
  • 23 Harris M, Farrell V, Houtkooper L. et al Associations of Polyunsaturated Fatty Acid Intake with Bone Mineral Density in Postmenopausal Women. Journal of Osteoporosis 2015; 2015
  • 24 Dawber TR, Meadors GF, Moore FE. Epidemiological approaches to heart disease - The Framingham Study. American Journal of Public Health 1951; 41: 279-286.
  • 25 Hodson L, Skeaff CM, Fielding BA. Fatty acid composition of adipose tissue and blood in humans and its use as a biomarker of dietary intake. Prog Lipid Res 2008; 47: 348-380.
  • 26 Hodson L, Harnden K, Banerjee R. et al Lower resting and total energy expenditure in postmenopausal compared with premenopausal women matched for abdominal obesity. J Nutr Sci 2014; 3: e3-e3.
  • 27 Orchard TS, Ing SW, Lu B. et al The association of red blood cell n-3 and n-6 fatty acids with bone mineral density and hip fracture risk in the women’s health initiative. J Bone Miner Res 2013; 28: 505-515.
  • 28 Paunescu AC, Ayotte P, Dewailly E. et al Polyunsaturated fatty acids and calcaneal ultrasound parameters among Inuit women from Nuuk (Greenland): a longitudinal study. Int J Circumpol Heal 2013; 72
  • 29 Eriksson S, Mellstrom D, Strandvik B. Fatty acid pattern in serum is associated with bone mineralisation in healthy 8-year-old children. Br J Nutr 2009; 102: 407-412.
  • 30 Hogstrom M, Nordstrom P, Nordstrom A. n-3 fatty acids are positively associated with peak bone mineral density and bone accrual in healthy men: the NO2 Study. Am J Clin Nutr 2007; 85: 803-807.
  • 31 Lappe J, Kunz I, Bendik I. et al Effect of a combination of genistein, polyunsaturated fatty acids and vitamins D3 and K1 on bone mineral density in postmenopausal women: a randomized, placebo-controlled, double-blind pilot study. Eur J Nutr 2013; 52: 203-215.
  • 32 Marini H, Minutoli L, Polito F. et al Effects of the Phytoestrogen Genistein on Bone Metabolism in Osteopenic Postmenopausal WomenA Randomized Trial. Annals of Internal Medicine 2007; 146: 839-847.
  • 33 Kruger MC, Coetzer H, de Winter R. et al Calcium, gamma-linolenic acid and eicosapentaenoic acid supplementation in senile osteoporosis. Aging Clin Exp Res 1998; 10: 385-394.
  • 34 Dodin S, Lemay A, Jacques H. et al The effects of flaxseed dietary supplement on lipid profile, bone mineral density, and symptoms in menopausal women: A randomized, double-blind, wheat germ placebo-controlled clinical trial. J Clin Endocrinol Metab 2005; 90: 1390-1397.
  • 35 Bassey EJ, Littlewood JJ, Rothwell MC, Pye DW. Lack of effect of supplementation with essential fatty acids on bone mineral density in healthy pre- and postmenopausal women: two randomized controlled trials of Efacal (R) v. calcium alone. Brit J Nutr 2000; 83: 629-635.
  • 36 Vanlint SJ, Ried K. Efficacy and tolerability of calcium, vitamin D and a plant-based omega-3 oil for osteopenia: A pilot RCT. Maturitas 2012; 71: 44-48.
  • 37 Cornish SM, Chilibeck PD. Alpha-linolenic acid supplementation and resistance training in older adults. Appl Physiol Nutr Metab 2009; 34: 49-59.
  • 38 Damsgaard CT, Molgaard C, Matthiessen J. et al The effects of n-3 long-chain polyunsaturated fatty acids on bone formation and growth factors in adolescent boys. Pediatr Res 2012; 71: 713-719.
  • 39 Griel AE. Kris-Etherton PM, Hilpert KF. et al An increase in dietary n-3 fatty acids decreases a marker of bone resorption in humans. Nutr J 2007; 6: 2
  • 40 Hutchins-Wiese HL, Picho K, Watkins BA. et al High-Dose Eicosapentaenoic Acid and Docosahexaenoic Acid Supplementation Reduces Bone Resorption in Postmenopausal Breast Cancer Survivors on Aromatase Inhibitors: A Pilot Study. Nutr Cancer 2014; 66: 68-76.
  • 41 Salari Sharif P, Asalforoush M, Ameri F. et al The effect of n-3 fatty acids on bone biomarkers in Iranian postmenopausal osteoporotic women: a randomized clinical trial. Age 2010; 32: 179-186.
  • 42 Martin-Bautista E, Munoz-Torres M, Fonolla J. et al Improvement of bone formation biomarkers after 1-year consumption with milk fortified with eicosapentaenoic acid, docosahexaenoic acid, oleic acid, and selected vitamins. Nutr Res 2010; 30: 320-326.
  • 43 Appleton KM, Fraser WD, Rogers PJ. et al Supplementation with a low-moderate dose of n-3 long-chain PUFA has no short-term effect on bone resorption in human adults. Brit J Nutr 2011; 105: 1145-1149.
  • 44 Dawczynski C, Schubert R, Hein G. et al Long-term moderate intervention with n-3 long-chain PUFA-supplemented dairy products: effects on pathophysiological biomarkers in patients with rheumatoid arthritis. Brit J Nutr 2009; 101: 1517-1526.
  • 45 Metkus TS, Timpone J, Leaf D. et al Omega-3 fatty acid therapy reduces triglycerides and interleukin-6 in hypertriglyeridemic HIV patients. Hiv Med 2013; 14: 530-539.
  • 46 Farina EK, Kiel DP, Roubenoff R. et al Plasma phosphatidylcholine concentrations of polyunsaturated fatty acids are differentially associated with hip bone mineral density and hip fracture in older adults: The framingham osteoporosis study. J Bone Miner Res 2012; 27: 1222-1230.