Subscribe to RSS
DOI: 10.1055/s-0042-117773
The Effects of Omega-3 Fatty Acids and Vitamin E Co-Supplementation on Indices of Insulin Resistance and Hormonal Parameters in Patients with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial

Abstract
Objective
This study was conducted to determine the effects of omega-3 fatty acids and vitamin E co-supplementation on indices of insulin resistance and hormonal parameters in women with polycystic ovary syndrome (PCOS).
Methods
This randomized double-blind, placebo-controlled trial was done on 68 women diagnosed with PCOS according to the Rotterdam criteria aged 18–40 years old. Participants were randomly assigned into 2 groups to receive either 1 000 mg omega-3 fatty acids from flaxseed oil containing 400 mg α-Linolenic acid plus 400 IU vitamin E supplements (n=34) or placebo (n=34) for 12 weeks. Hormonal parameters were quantified at the beginning of the study and after 12-week intervention.
Results
After 12 weeks of intervention, compared to the placebo, omega-3 fatty acids and vitamin E co-supplementation resulted in a significant decrease in insulin (−1.0±3.5 vs. +2.7±6.6 µIU/mL, P=0.004), homeostasis model of assessment-estimated insulin resistance (−0.2±0.8 vs. +0.6±1.5, P=0.005), homeostasis model of assessment-estimated B cell function (−4.3±14.3 vs. +10.5±24.5, P=0.004) and a significant increase in quantitative insulin sensitivity check index (+0.006±0.02 vs. −0.01±0.04, P=0.008). Supplementation with omega-3 fatty acids plus vitamin E led to significant reductions in serum total testosterone (−0.5±0.7 vs. −0.1±0.5 ng/mL, P=0.008) and free testosterone (−1.2±2.1 vs. −0.2±1.7, P=0.04) compared to the placebo group. We did not observe any significant effect of omega-3 fatty acids and vitamin E co-supplementation on fasting plasma glucose and other hormonal profiles.
Conclusions
Omega-3 fatty acids and vitamin E co-supplementation for 12 weeks in PCOS women significantly improved indices of insulin resistance, total and free testosterone.
Publication History
Received: 31 May 2016
Received: 09 September 2016
Accepted: 21 September 2016
Article published online:
13 April 2017
© 2017. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1
Dunaif A.
Insulin resistance and the polycystic ovary syndrome: mechanism and implications for
pathogenesis. Endocr Rev 1997; 18: 774-800
MissingFormLabel
- 2
Tsilchorozidou T,
Overton C,
Conway GS.
The pathophysiology of polycystic ovary syndrome. Clin Endocrinol (Oxf) 2004; 60:
1-17
MissingFormLabel
- 3
Jamil AS,
Alalaf SK,
Al-Tawil NG.
et al. A case-control observational study of insulin resistance and metabolic syndrome
among the four phenotypes of polycystic ovary syndrome based on Rotterdam criteria.
Reprod Health 2015; 12: 7
MissingFormLabel
- 4
Boudreaux MY,
Talbott EO,
Kip KE.
et al. Risk of T2DM and impaired fasting glucose among PCOS subjects: results of an
8-year follow-up. Curr Diab Rep 2006; 6: 77-83
MissingFormLabel
- 5
Talbott E,
Clerici A,
Berga SL.
et al. Adverse lipid and coronary heart disease risk profiles in young women with
polycystic ovary syndrome: results of a case-control study. J Clin Epidemiol 1998;
51: 415-422
MissingFormLabel
- 6
Asemi Z,
Samimi M,
Tabassi Z.
et al. Effects of DASH diet on lipid profiles and biomarkers of oxidative stress in
overweight and obese women with polycystic ovary syndrome: a randomized clinical trial.
Nutrition 2014; 30: 1287-1293
MissingFormLabel
- 7
Asemi Z,
Esmaillzadeh A.
DASH diet, insulin resistance, and serum hs-CRP in polycystic ovary syndrome: a randomized
controlled clinical trial. Horm Metab Res 2015; 47: 232-238
MissingFormLabel
- 8
Roche HM.
Fatty acids and the metabolic syndrome. Proc Nutr Soc 2005; 64: 23-29
MissingFormLabel
- 9
Mohammadi E,
Rafraf M,
Farzadi L.
et al. Effects of omega-3 fatty acids supplementation on serum adiponectin levels
and some metabolic risk factors in women with polycystic ovary syndrome. Asia Pac
J Clin Nutr 2012; 21: 511-518
MissingFormLabel
- 10
Liepa GU,
Sengupta A,
Karsies D.
Polycystic ovary syndrome (PCOS) and other androgen excess-related conditions: can
changes in dietary intake make a difference?. Nutr Clin Pract 2008; 23: 63-71
MissingFormLabel
- 11
Phelan N,
O’Connor A,
Kyaw Tun T.
et al. Hormonal and metabolic effects of polyunsaturated fatty acids in young women
with polycystic ovary syndrome: results from a cross-sectional analysis and a randomized,
placebo-controlled, crossover trial. Am J Clin Nutr 2011; 93: 652-662
MissingFormLabel
- 12
Rafraf M,
Mohammadi E,
Asghari-Jafarabadi M.
et al. Omega-3 fatty acids improve glucose metabolism without effects on obesity values
and serum visfatin levels in women with polycystic ovary syndrome. J Am Coll Nutr
2012; 31: 361-368
MissingFormLabel
- 13
Paolisso G,
D’Amore A,
Giugliano D.
et al. Pharmacologic doses of vitamin E improve insulin action in healthy subjects
and non-insulin-dependent diabetic patients. Am J Clin Nutr 1993; 57: 650-656
MissingFormLabel
- 14
Delarue J,
Guillodo MP,
Guillerm S.
et al. Fish oil attenuates adrenergic overactivity without altering glucose metabolism
during an oral glucose load in haemodialysis patients. Br J Nutr 2008; 99: 1041-1047
MissingFormLabel
- 15
Barbagallo M,
Dominguez LJ,
Tagliamonte MR.
et al. Effects of vitamin E and glutathione on glucose metabolism: role of magnesium.
Hypertension 1999; 34: 1002-1006
MissingFormLabel
- 16
Asemi Z,
Soleimani A,
Bahmani F.
et al. Effect of the omega-3 fatty acid plus vitamin E supplementation on subjective
global assessment score, glucose metabolism, and lipid concentrations in chronic hemodialysis
patients. Mol Nutr Food Res 2016; 60: 390-398
MissingFormLabel
- 17
Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group
.
Revised 2003 consensus on diagnostic criteria and long-term health risks related to
polycystic ovary syndrome. Fertil Steril 2004; 81: 19-25
MissingFormLabel
- 18
Huang A,
Brennan K,
Azziz R.
Prevalence of hyperandrogenemia in the polycystic ovary syndrome diagnosed by the
National Institutes of Health 1990 criteria. Fertil Steril 2010; 93: 1938-1941
MissingFormLabel
- 19
Ainsworth BE,
Haskell WL,
Whitt MC.
et al. Compendium of physical activities: an update of activity codes and MET intensities.
Med Sci Sports Exerc 2000; 32: S498-S504
MissingFormLabel
- 20
Taghizadeh M,
Jamilian M,
Mazloomi M.
et al. A randomized-controlled clinical trial investigating the effect of omega-3
fatty acids and vitamin E co-supplementation on markers of insulin metabolism and
lipid profiles in gestational diabetes. J Clin Lipidol 2016; 10: 386-393
MissingFormLabel
- 21
Hatch R,
Rosenfield RL,
Kim MH.
et al. Hirsutism: implications, etiology, and management. Am J Obstet Gynecol 1981;
140: 815-830
MissingFormLabel
- 22
Pisprasert V,
Ingram KH,
Lopez-Davila MF.
et al. Limitations in the use of indices using glucose and insulin levels to predict
insulin sensitivity: impact of race and gender and superiority of the indices derived
from oral glucose tolerance test in African Americans. Diabetes Care 2013; 36: 845-853
MissingFormLabel
- 23
Asemi Z,
Foroozanfard F,
Hashemi T.
et al. Calcium plus vitamin D supplementation affects glucose metabolism and lipid
concentrations in overweight and obese vitamin D deficient women with polycystic ovary
syndrome. Clin Nutr 2015; 34: 586-592
MissingFormLabel
- 24
Hutchins AM,
Brown BD,
Cunnane SC.
et al. Daily flaxseed consumption improves glycemic control in obese men and women
with pre-diabetes: a randomized study. Nutr Res 2013; 33: 367-375
MissingFormLabel
- 25
Nestel PJ,
Pomeroy SE,
Sasahara T.
et al. Arterial compliance in obese subjects is improved with dietary plant n-3 fatty
acid from flaxseed oil despite increased LDL oxidizability. Arterioscler Thromb Vasc
Biol 1997; 17: 1163-1170
MissingFormLabel
- 26
D’Adamo E,
Marcovecchio ML,
Giannini C.
et al. Improved oxidative stress and cardio-metabolic status in obese prepubertal
children with liver steatosis treated with lifestyle combined with Vitamin E. Free
Radic Res 2013; 47: 146-153
MissingFormLabel
- 27
Barre DE,
Mizier-Barre KA,
Griscti O.
et al. High dose flaxseed oil supplementation may affect fasting blood serum glucose
management in human type 2 diabetics. J Oleo Sci 2008; 57: 269-273
MissingFormLabel
- 28
Manning PJ,
Sutherland WH,
Williams SM.
et al. The effect of lipoic acid and vitamin E therapies in individuals with the metabolic
syndrome. Nutr Metab Cardiovasc Dis 2013; 23: 543-549
MissingFormLabel
- 29
Glintborg D,
Henriksen JE,
Andersen M.
et al. Prevalence of endocrine diseases and abnormal glucose tolerance tests in 340
Caucasian premenopausal women with hirsutism as the referral diagnosis. Fertil Steril
2004; 82: 1570-1579
MissingFormLabel
- 30
Wu JH,
Cahill LE,
Mozaffarian D.
Effect of fish oil on circulating adiponectin: a systematic review and meta-analysis
of randomized controlled trials. J Clin Endocrinol Metab 2013; 98: 2451-2459
MissingFormLabel
- 31
Yamauchi T,
Kamon J,
Minokoshi Y.
et al. Adiponectin stimulates glucose utilization and fatty-acid oxidation by activating
AMP-activated protein kinase. Nat Med 2002; 8: 1288-1295
MissingFormLabel
- 32
Altavilla D,
Deodato B,
Campo GM.
et al. IRFI 042, a novel dual vitamin E-like antioxidant, inhibits activation of nuclear
factor-kappaB and reduces the inflammatory response in myocardial ischemia-reperfusion
injury. Cardiovasc Res 2000; 47: 515-528
MissingFormLabel
- 33
Nadjarzadeh A,
Dehghani Firouzabadi R,
Vaziri N.
et al. The effect of omega-3 supplementation on androgen profile and menstrual status
in women with polycystic ovary syndrome: A randomized clinical trial. Iran J Reprod
Med 2013; 11: 665-672
MissingFormLabel
- 34
Akinsete JA,
Ion G,
Witte TR.
et al. Consumption of high omega-3 fatty acid diet suppressed prostate tumorigenesis
in C3(1) Tag mice. Carcinogenesis 2012; 33: 140-148
MissingFormLabel
- 35
Cussons AJ,
Watts GF,
Mori TA.
et al. Omega-3 fatty acid supplementation decreases liver fat content in polycystic
ovary syndrome: a randomized controlled trial employing proton magnetic resonance
spectroscopy. J Clin Endocrinol Metab 2009; 94: 3842-3848
MissingFormLabel
- 36
Oner G,
Muderris II.
Efficacy of omega-3 in the treatment of polycystic ovary syndrome. J Obstet Gynaecol
2013; 33: 289-291
MissingFormLabel