Omega-3 polyunsaturated fatty acids in treating non-alcoholic steatohepatitis: A randomized, double-blind, placebo-controlled trial

卷:35

Nogueira, Monize Aydar ; Oliveira, Claudia Pinto ; Ferreira Alves, Venancio Avancini ; Stefano, Jose Tadeu ; dos Reis Rodrigues, Livia Samara ; Torrinhas, Raquel Susana ; Cogliati, Bruno ; Barbeiro, Hermes ; Carrilho, Flair Jose ; Waitzberg, Dan Linetzky

Univ Sao Paulo

关键词: Alpha-linolenic acid;    Eicosapentaenoic acid;    Docosahexaenoic acid;    Flaxseed oil;    Fish oil;    Nonalcoholic steatohepatitis;   

DOI  :  10.1016/j.clnu.2015.05.001

学科分类：食品科学和技术

【 摘 要 】

Background: & aims: Few clinical trials have addressed the potential benefits of omega-3 polyunsaturated fatty acids (PUFAs) on non-alcoholic steatohepatitis (NASH). We evaluated the effects of supplementation with omega-3 PUFAs from flaxseed and fish oils in patients with biopsy-proven NASH. Methods: Patients received three capsules daily, each containing 0315 g of omega-3 PUFAs (64% alpha-linolenic [ALA], 16% eicosapentaenoic [EPA], and 21% docosahexaenoic [DHA] acids; n-3 group, n = 27) or mineral oil (placebo group, n = 23). Liver biopsies were evaluated histopathologically by the NASH activity score (NAS). Plasma levels of omega-3 PUFAs were assessed as a marker of intake at baseline and after 6 months of treatment. Secondary endpoints included changes in plasma biochemical markers of lipid metabolism, inflammation, and liver function at baseline and after 3 and 6 months of treatment. Results: At baseline, NAS was comparable between the groups (p = 0.98). After intervention with omega 3 PUFAs, plasma ALA and EPA levels increased (p <= 0.05). However in the placebo group, we also observed increased EPA and DHA (p <= 0.05), suggesting an off-protocol intake of PUFAs. NAS improvement/stabilization was correlated with increased ALA in the n-3 group (p = 0.02) and with increased EPA (p = 0.04) and DHA (p = 0.05) in the placebo group. Triglycerides were reduced after 3 months in the n-3 group compared to baseline (p = 0.01). Conclusions: In NASH patients, the supplementation of omega-3 PUFA from flaxseed and fish oils significantly impacts on plasma lipid profile of patients with NASH. Plasma increase of these PUFAs was associated with better liver histology. (C) 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.