The effects of omega-3 fatty acids and vitamin E co-supplementation on gene expression of lipoprotein(a) and oxidized low-density lipoprotein, lipid profiles and biomarkers of oxidative stress in patients with polycystic ovary syndrome

A 12-week placebo-controlled study in women with polycystic ovary syndrome aged 18-40 years in Kashan, Iran. Thirty-four participants were assigned to omega-3 fatty acids plus vitamin E and 34 to placebo, with intention-to-treat analysis including all 68 randomized women. All participants were receiving metformin during the trial.

Omega-3 fatty acids from flaxseed oil 1000 mg, providing 400 mg alpha-linolenic acid, plus vitamin E 400 IU, administered orally as capsules for 12 weeks and compared with placebo.

Omega-3 fatty acids plus vitamin E improved PCOS-related biomarker profiles after 12 weeks. Lp(a) mRNA and Ox-LDL mRNA were both downregulated versus placebo (P<0.001 for both). Compared with placebo, triglycerides decreased by -22.1±22.3 mg/dL versus +7.7±23.6, VLDL by -4.4±4.5 versus +1.5±4.7, total cholesterol by -20.3±16.6 versus +12.2±26.1, LDL-cholesterol by -16.7±15.3 versus +11.9±26.1, and total-/HDL-cholesterol by -0.5±0.6 versus +0.4±0.8. TAC increased and MDA decreased relative to placebo, while HDL-cholesterol and GSH did not show a meaningful effect.

The trial was small, single-center, and only 12 weeks long, which limits confidence and generalizability. Outcomes were mainly surrogate biomarkers rather than clinical endpoints. All participants were also taking metformin, and adverse events were not reported in the extracted text.