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The effects of omega-3 on blood pressure and the relationship between serum visfatin level and blood pressure in patients with type II diabetes.
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MedLine Citation:
PMID:  23056097     Owner:  NLM     Status:  PubMed-not-MEDLINE    
BACKGROUND: Hypertension is a condition normally detected in people with type II diabetes.It eventually leads to cardiovascular diseases in the patient. Visfatin is an adipocytokine which issecreted from adipose tissue and can affect the inflammatory reaction and also serum lipidlevels. Additionally, omega-3 inhibits the accumulation of fat and formation of insulinresistance. The current study tried to investigate the effects of omega-3 on blood pressurecompared to placebo and the relationship between serum visfatin levels and blood pressure.
METHODS: A total number of 71 women with type II diabetes were randomly assigned to2 groups to receive either omega-3 capsules or placebo capsules. In the first step, aquestionnaire consisting age, height, weight, waist and hip circumferences, and systolic anddiastolic blood pressure was filled out for each subject. Blood samples were then collected forlaboratory tests. The next step was to conduct 8 weeks of intervention. All variables, except age,were measured again after the intervention. Hip circumference was considered as the maximumcircumference of the buttocks. Waist circumference was measured by placing a tape horizontallyacross the abdomen at the end of a normal exhalation. Laboratory tests included the assessmentof visfatin, glucose, and glycated hemoglobin (HbA1c) concentrations. Lipid profile, i.e. lowdensity lipoprotein (LDL), high density lipoprotein (HDL), triglyceride (TG), and cholesterol,was also assessed. Using SPSS18, data obtained from the study was analyzed by a variety ofappropriate statistical tests.
RESULTS: There was a significant change in mean differences of systolic and diastolic bloodpressure. Blood pressure showed a significant reduction in the omega-3 group compared to theplacebo group. However, no significant changes were observed in systolic and diastolic bloodpressure before and after the intervention (P > 0.05).
CONCLUSION: Based on the results of this study, a daily consumption of omega-3 is suggestedfor patients with type II diabetes.
Mohammad Javad Hosseinzadeh Atar; Hossein Hajianfar; Ahmad Bahonar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  ARYA atherosclerosis     Volume:  8     ISSN:  2251-6638     ISO Abbreviation:  ARYA Atheroscler     Publication Date:  2012  
Date Detail:
Created Date:  2012-10-11     Completed Date:  2012-10-12     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  101487337     Medline TA:  ARYA Atheroscler     Country:  Iran    
Other Details:
Languages:  eng     Pagination:  27-31     Citation Subset:  -    
Associate Professor, Department of Nutrition, Tehran University of Medical Sciences International Campus, Tehran, Iran.
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Journal Information
Journal ID (nlm-ta): ARYA Atheroscler
Journal ID (iso-abbrev): ARYA Atheroscler
Journal ID (publisher-id): ARYA
ISSN: 1735-3955
ISSN: 2251-6638
Publisher: Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences
Article Information
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© 2011 Isfahan Cardiovascular Research Center & Isfahan University of Medical Sciences
Received Day: 11 Month: 12 Year: 2011
Accepted Day: 10 Month: 3 Year: 2012
Print publication date: Season: Spring Year: 2012
Volume: 8 Issue: 1
First Page: 27 Last Page: 31
ID: 3448398
PubMed Id: 23056097
Publisher Id: ARYA-08-27

The effects of omega-3 on blood pressure and the relationship between serum visfatin level and blood pressure in patients with type II diabetes
Mohammad Javad Hosseinzadeh Atar(1)
Hossein Hajianfar(2)
Ahmad Bahonar(3)
1Associate Professor, Department of Nutrition, Tehran University of Medical Sciences International Campus, Tehran, Iran
2MSc, Tehran University of Medical Sciences International Campus, Tehran, Iran
3General Practitioner, Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
Correspondence: Correspondence To: Hossein Hajianfar, Email:


According to the World Health Organization (WHO), 150 million people are currently suffering from type II diabetes. This figure is predicted to be doubled by the year 2025.1 Today, the disease is detected in all age groups, including women and high risk groups. Mortality rates in diabetic individuals after adjusting for age is 1.5-2.5 times more than total population.2 Since in most cases, insulin resistance and diabetes are associated with obesity, obesity and overweight are considered as the major causes of diabetes and insulin resistance.3

In addition, hypertension is common in people with diabetes and its prevalence increases substantially over time. On the other hand, omega-3 intake may reduce blood pressure.4 Alpha lipoic acid reduces hypertension in people with type II diabetes.5 The prevalence of hypertension in creases with age in both sexes.6,7 In 1989, one fourth of America's total population and one third of its adults suffered from high blood pressure. At the same time, hypertension developed in 30% of urban community adults in the East Mediterranean region.8 Visfatin is an adiponectin with insulin-like function9,10 which was discovered in adipose tissues by Fukuhara et al. in 2005.11 Omega 3 increases visfatin secretion in patients with type II diabetes.12 Obesity can lead to hyperplasia and hypertrophy of fat cells which secrete a variety of compounds with exert critical roles in the pathogenesis of diseases such as metabolic syndrome, hypertension, insulin resistance, and cardiovascular diseases.13

Omega-3 fatty acids have been demonstrated to reduce cholesterol, triglycerides, inflammation, cardiovascular diseases, and cancer. They may also prevent insulin resistance. Omega-3 fatty acids downregulate the expression of genes and hormones (such as leptin) involved in obesity. They also prevent the construction of omega-6 compounds. In type II diabetics, consumption of over 4 grams of eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA) can increase serum glucose and reduce triglyceride.14

Visfatin is a regulator of fat metabolism15 which has a direct relation with body mass index (BMI).16 Being directly relate with waist to hip ratio (WHR), serum visfatin level is higher in diabetics compared to normal healthy people.11

This study was designed to investigate whether omega-3 lowers blood pressure in diabetics and if there is any significant relationship between serum visfatin level and blood pressure in people with type II diabetes.

Materials and Methods

This was a double-blind randomized controlled clinical study. The study population included 45-65 year-old female type II diabetes patients who referred to Charity Center of Diabetes in Isfahan, Iran. Using a formula and considering 15% additional samples, the sample size in each group was calculated as 39 in each group. Women were only included if they had at least a 5-year history of type II diabetes. Exclusion criteria were injecting insulin, having secondary complications of diabetes such as ophthalmic or renal complications and amputation, and having inflammatory diseases with C-reactive protein (CRP) levels of +++ or more. Finally, 39 patients in the omega-3 group and 34 subjects in the placebo group completed the study.

This study was approved by the Ethics Committee of Tehran University of Medical Sciences, Tehran, Iran. The participants were informed about the study procedure. They were then requested to sign the consent form. The subjects were randomly divided into two groups of omega-3 supplement recipients and placebo recipients. The omega-3 group received two omega-3 capsules containing 1,000 mg omega-3, 65% EPA (360 mg), and 35% DHA (240 mg) daily for 8 weeks. The placebo group received two placebo capsules containing 1 g of cornstarch for the same period.

The current study was performed in three phases. In the first phase, all patients filled out a questionnaire including age, height, weight, waist circumference, hip circumference, and systolic and diastolic blood pressure. Blood samples were also collected for blood tests. In the second stage, after 8 weeks of intervention, the same parameters were measured and blood samples were obtained again. Hip circumference was measured at the widest part. Waist circumference was also measured by a cord at the end of a normal exhalation. Blood pressure was measured by a mercury sphygmomanometer in a sitting position and after 10 minutes of rest.

Visfatin level was measured by standard kits using enzyme-linked immunosorbent assay (ELISA) method with a sensitivity of 30 pg/ml (Human Visfatin Kit, Adipogen Inc., South Korea). Both the examiner and the participants were blinded to the intervention. Blood sampling was conducted after 10-12 hours of fasting (10 cc in each time) before taking the anti-diabetic tablets.

All the tests were conducted automatically by Hitachi 911. Data was analyzed using SPSS18 (SPSS Inc., Chicago, IL, US). The Fisher's exact test was used to analyze qualitative data and student's t-test for quantitative data. Weight changes were analyzed by chi-square test while Pearson's correlation test was used to assess correlations. Moreover, paired t-test was used for comparing blood pressure changes before and after the intervention in both groups and independent t- test was used for comparing mean concentration changes between the two groups. To detect the correlations between variables, Pearson's regression analysis was used.


The results showed no significant differences in the mean baseline values of age, socioeconomic characteristics such as educational status and occupation, health status, medication consumption and dietary intake between omega-3 and placebo groups. Therefore, these variables had probably no confounding effect. The mean age of omega-3 and placebo groups were 53.6 ± 4.3 and 53.9 ± 5.4 years, respectively. Student's t-test showed no significant differences in the mean ages of the two groups (P = 0.79). Table 1 presents the obtained data on BMI, weight, and systolic and diastolic blood pressure.

Although the comparison of values of before and after intervention showed no significant changes in the mean BMI within groups, there were significant differences in the mean BMI between groups. The same trend was observed for weight, as the changes after the intervention in each group were not significant compared to the value before the intervention but significant once comparing the two groups.

The findings of this study revealed that the blood pressure of individuals who received placebo showed an upward trend during the intervention. However, omega-3 was able to reduce blood pressure in diabetics. Significant differences were thus detected between the two groups.

While at baseline, there were no significant changes in the mean systolic blood pressure within groups, the mean differences between groups were significant after the intervention (P = 0.003). Diastolic blood pressure had a similar trend. No significant differences within groups were observed before and after the study though, with a P of 0.002 the mean changes of DBP in omega-3 group significantly differed with what measured in placebo group. No significant changes were detected between systolic and diastolic blood pressure before and after the intervention (Tables 2 and 3).


The current study evaluated the efficacy of omega-3 on blood pressure in type II diabetic patients. It also assessed the relationship between visfatin and blood pressure. The results showed that consumption of omega-3 was effective in people with type 2 diabetes since it increased visfatin12 and might have lowered blood pressure. There were no relationships between visfatin serum levels and systolic or diastolic blood pressure. Haider et al.9 and 2 studies by Dogru etal.17,18 reported similar results.

Unlike the studies by Berndt et al.19 and Krzyzanowska et al.20 but similar to the obtained results by Fukuhara et al.11 and Chen et al.,11 the current study indicated a significant positive relationship between the amount of abdominal obesity and serum levels of visfatin in patients with diabetes.

In addition, identical to our results, some previous studies showed no significant relationship between circulating visfatin levels and BMI.9,10,19,21 On the contrary, the findings of the studies by Pagano et al. on obese nondiabetics22 and Samara et al. on nondiabetic individuals with different weights23 showed an inverse relationship between BMI and circulating visfatin levels.

On the other hand, Chen et al. found a significant relationship between BMI and circulating visfatin levels in patients with diabetes.9

Generally, the amount of visceral fat or abdominal obesity and body fat, are determined by WHR and BMI, respectively.19 Some researches have revealed that consumption of omega-3 can burn more body fat and increase metabolism, causing weight loss in patients.24 In the present study, BMI, as measured by weight, decreased in patients taking omega-3 and increased in the placebo group. Kesavulu et al. proved that omega-3 supplements had beneficial effects on triglyceride, high-density lipoprotein cholesterol, lipid peroxidation, and antioxidant enzymes, which eventually lowered vascular complications in diabetics.25 In 1991, Malasanos and Stacpoole conducted a study on patients with type 2 diabetes. They suggested that EPA could lower the levels of serum lipids and lipoproteins, increase fluidity of cell membranes, and reduce platelet aggregation and blood pressure.26 Omega-3 intake has also been suggested to have a weight control effect on diabetics.27,28

In 2007, Dogru et al. conducted a study on 33 young patients who had recently been diagnosed with hypertension. It investigated the relationship between visfatin and blood pressure. To omit the possible confounding effects and relations between BMI and visfatin, patients with BMIs less than 25 were recruited to the study. However, no significant relationship was detected between serum visfatin level and blood pressure which was identical with the results achieved in this study.18 It has also been shown that the insulin receptor is associated with hypertension.13 Moreover, the insulin receptor and inflammation can be effective on the development of hypertension.29 However, our results did not support this role for visfatin.


Based on the positive effects of omega-3 on hypertension, daily consupmtion of omega-3 supplements for diabetics and individuals at high risk is highly recommended.


Conflicts of Interest

Authors have no conflict of interests.


This article was derived from MSc thesis in the Isfahan University of Medical Sciences, No: IRCT138903164109N1.

1. King H,Aubert RE,Herman WH. Global burden ofdiabetes, 1995-2025: prevalence, numericalestimates, and projections.Diabetes CareYear: 19982191414319727886
2. Jung CH,Rhee EJ,Kim SY,Shin HS,Kim BJ,Sung KC,et al. Associations between two single nucleotidepolymorphisms of adiponectin gene and coronaryartery diseases.Endocr JYear: 2006535671716926524
3. Kleinman JC,Donahue RP,Harris MI,Finucane FF,Madans JH,Brock DB. Mortality among diabetics ina national sample.Am J EpidemiolYear: 198812823894013394705
4. Tribole E. The Ultimate Omega-3 Diet: Maximize the Power of Omega-3s to Supercharge Your Health, Battle Inflammation, and Keep Your Mind Sharp.New YorkMcGraw-Hill ProfessionalYear: 2007
5. Mazlom Z,Ansari H. Effect of anti oxidan Alfa lipoicacid on blood presur in patient with type 2 diabetes .Iranian Journal of Endocrinology and MetabolismYear: 200911324550
6. Schlat RC. The heart.8th edNew YorkMcGrawHillYear: 1994p. 190-22
7. Finau SA,Prior IA,Salmond CE. Hypertensionamong urban and rural Tongans.Med J AustYear: 1986144116203484537
8. Alwan A. Prevention and control of cardiovascular diseases.GenevaWorld Health OrganizationYear: 1995p. 21
9. Chen MP,Chung FM,Chang DM,Tsai JC,Huang HF,Shin SJ,et al. Elevated plasma level ofvisfatin/pre-B cell colony-enhancing factor in patientswith type 2 diabetes mellitus.J Clin EndocrinolMetabYear: 20069112959
10. Haider DG,Schindler K,Schaller G,Prager G,Wolzt M,Ludvik B. Increased plasma visfatinconcentrations in morbidly obese subjects are reducedafter gastric banding.J Clin Endocrinol MetabYear: 200691415788116449335
11. Fukuhara A,Matsuda M,Nishizawa M,Segawa K,Tanaka M,Kishimoto K,et al. Visfatin: a proteinsecreted by visceral fat that mimics the effects ofinsulin.ScienceYear: 200530757084263015604363
12. Bailey SD,Loredo-Osti JC,Lepage P,Faith J,Fontaine J,Desbiens KM,et al. Commonpolymorphisms in the promoter of the visfatin gene(PBEF1) influence plasma insulin levels in a French-Canadian population.DiabetesYear: 20065510289690217003359
13. Reaven GM. Insulin resistance/compensatoryhyperinsulinemia, essential hypertension, andcardiovascular disease.J Clin Endocrinol MetabYear: 2003886239940312788834
14. Shils ME,Shike M,Ross AC,Caballero B,Cousins RJ. Modern Nutrition In Health And DiseasePhiladelphiaLippincott Williams & WilkinsYear: 2006p. 1053
15. Sun G,Bishop J,Khalili S,Vasdev S,Gill V,Pace D,et al. Serum visfatin concentrations are positivelycorrelated with serum triacylglycerols and downregulatedby overfeeding in healthy young men.Am JClin NutrYear: 200785239940417284735
16. Varma V,Yao-Borengasser A,Rasouli N,Bodles AM,Phanavanh B,Lee MJ,et al. Human visfatinexpression: relationship to insulin sensitivity,intramyocellular lipids, and inflammation.J ClinEndocrinol MetabYear: 200792266672
17. Dogru T,Sonmez A,Tasci I,Bozoglu E,Yilmaz MI,Genc H,et al. Plasma visfatin levels in patients withnewly diagnosed and untreated type 2 diabetesmellitus and impaired glucose tolerance.DiabetesRes Clin PractYear: 2007761249
18. Dogru T,Sonmez A,Tasci I,Yilmaz MI,Erdem G,Erturk H,et al. Plasma visfatin levels in young malepatients with uncomplicated and newly diagnosedhypertension.J Hum HypertensYear: 2007212173517096008
19. Berndt J,Kloting N,Kralisch S,Kovacs P,Fasshauer M,Schon MR,et al. Plasma visfatin concentrationsand fat depot-specific mRNA expression in humans.DiabetesYear: 200554102911616186392
20. Krzyzanowska K,Krugluger W,Mittermayer F,Rahman R,Haider D,Shnawa N,et al. Increasedvisfatin concentrations in women with gestationaldiabetes mellitus.Clin Sci (Lond)Year: 20061105605916489932
21. Sandeep S,Velmurugan K,Deepa R,Mohan V. Serum visfatin in relation to visceral fat, obesity, andtype 2 diabetes mellitus in Asian Indians.MetabolismYear: 20075645657017379018
22. Pagano C,Pilon C,Olivieri M,Mason P,Fabris R,Serra R,et al. Reduced plasma visfatin/pre-B cellcolony-enhancing factor in obesity is not related toinsulin resistance in humans.J Clin Endocrinol MetabYear: 200691831657016720654
23. Samara A,Pfister M,Marie B,Visvikis-Siest S. Visfatin, low-grade inflammation and body mass index(BMI).Clin Endocrinol (Oxf)Year: 20086945687418248642
24. Mori TA,Bao DQ,Burke V,Puddey IB,Beilin LJ. Docosahexaenoic acid but not eicosapentaenoic acidlowers ambulatory blood pressure and heart rate inhumans.HypertensionYear: 19993422536010454450
25. Kesavulu MM,Kameswararao B,Apparao C,Kumar EG,Harinarayan CV. Effect of omega-3 fatty acidson lipid peroxidation and antioxidant enzyme status in type2 diabetic patients.Diabetes MetabYear: 200228120611938024
26. Malasanos TH,Stacpoole PW. Biological effects ofomega-3 fatty acids in diabetes mellitus.DiabetesCareYear: 19911412116079
27. Wu LY,Juan CC,Ho LT,Hsu YP,Hwang LS. Effectof green tea supplementation on insulin sensitivity inSprague-Dawley rats.J Agric Food ChemYear: 2004523643814759162
28. Wolfram S,Raederstorff D,Preller M,Wang Y,Teixeira SR,Riegger C,et al. Epigallocatechingallate supplementation alleviates diabetes in rodents.J NutrYear: 2006136102512816988119
29. Bautista LE. Inflammation, endothelial dysfunction,and the risk of high blood pressure: epidemiologicand biological evidence.J Hum HypertensYear: 20031742233012692566

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Keywords: Omega 3, Visfatin, Hypertension, Type 2 Diabetes Mellitus..

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