Association between omega-6 fatty acids and diabetic retinopathy risk: a systematic review and meta-analysis
Abstract
Background: Diabetic retinopathy (DR) is a progressive microvascular complication of diabetes and a leading cause of vision loss worldwide. Despite advances in glycemic and ophthalmologic management, additional modifiable factors influencing DR onset and progression require further exploration. Emerging evidence suggests a pivotal role of omega-6 polyunsaturated fatty acids in retinal vascular health.
Objectives: To systematically synthesize and quantify associations between omega-6 fatty acids, including linoleic acid (LA), arachidonic acid (AA), and related metabolites, and the incidence, presence, progression, predictive performance, and reported adverse or non-retinal clinical outcomes of diabetic retinopathy (DR) among individuals with diabetes.
Methods: A comprehensive systematic search was conducted across PubMed, Embase, Web of Science, Scopus, Cochrane Library, ScienceDirect, Wiley Online Library, EBSCO Open Research, and Google Scholar from database inception to August 15, 2025. Eligible studies included randomized trials, cohort studies, case-control studies, cross-sectional studies, and Mendelian randomization analyses that evaluated omega-6 fatty acid exposure, circulating omega-6 biomarkers, or omega-6-related metabolites in relation to DR. Quantitative synthesis was performed only for outcomes with sufficient methodological and clinical comparability. Predictive-model studies and Mendelian randomization evidence were synthesized separately. Publication bias…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 400,000 participants or records.
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