Impact of Long-Term Supplementation with Fish Oil in Individuals with Non-Alcoholic Fatty Liver Disease: A Double Blind Randomized Placebo Controlled Clinical Trial.

Kátia Cansanção,Marta Citelli,Alberto Dávalos,María-Carmen López De Las Hazas,Maria Das Graças Tavares Do Carmo,Nathalie Carvalho Leite,Wilza Arantes Ferreira Peres

doi:10.3390/nu12113372

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a chronic disease affecting up to 25% of the population worldwide. n-3 long-chain polyunsaturated fatty acids (n-3 PUFA) have been associated with improved clinical parameters of NAFLD. Our purpose was to conduct a pilot study to evaluate the effects of n-3 PUFA supplementation in a randomized, double-blind, placebo-controlled clinical study performed on NAFLD individuals diagnosed by ultrasound. Patients received n-3 PUFA (n = 13) or placebo (n = 11) supplementation for six months. Circulating miR-122 expression (determined by quantitative real time-polymerase chain reaction (qRT-PCR), liver fibrosis (FibroScan®), red blood cells (RBC) fatty acids (gas chromatography), and biochemical tests were performed at baseline and after intervention. After the intervention, in the n-3 PUFA group, docosahexaenoic acid (DHA) and omega index increased significantly in RBC (p = 0.022 and p = 0.012, respectively), in addition to a significant reduction in alkaline phosphatase (ALP) (p = 0.002) and liver fibrosis (p = 0.039). However, there was no change in the expression of circulating miR-122 in both groups. Our results showed that omega-3 PUFA were incorporated in erythrocytes after six months of fish oil supplementary intake, and that n-3 PUFA were effective in reducing ALP and liver fibrosis without altering the expression of circulating miR-122 in individuals with NAFLD.

Highlights

Over the past few decades, non-alcoholic fatty liver disease (NAFLD) has emerged as the leading cause of chronic liver disease worldwide, affecting approximately 25% of the general population [1].Its progression can lead to non-alcoholic steatohepatitis (NASH), and advanced liver fibrosis is considered an independent risk factor for mortality [2]
The main factors that led to segment loss were irregular capsule ingestion, refusal to continue, diagnosis of cancer during the study, diarrhea, and nausea (Figure 1)
Unlike other studies reporting a reduction in the hepatic enzymes alanine transaminase (ALT), AST, or gamma-glutamyl transferase (GGT) [13,14,15,16,17,18,19,20], after the supplementation of n-3 PUFA, we found a reduction in the levels of ALP, which is Similar results were found previously by Tobin et al [15], who demonstrated a significant increase in the omega index in the intervention group compared to the placebo group after 24 weeks of follow-up

Summary

Introduction

Its progression can lead to non-alcoholic steatohepatitis (NASH), and advanced liver fibrosis is considered an independent risk factor for mortality [2]. This complex multifactorial disease is related to several factors such as insulin resistance (IR), dysregulation of lipid metabolism, diet, Nutrients 2020, 12, 3372; doi:10.3390/nu12113372 www.mdpi.com/journal/nutrients. Its current treatment is limited to controlling associated comorbidities and to healthier lifestyle changes, which are hard to maintain in the long-term [5,6] In this sense, additional therapies have been investigated, and among the various compounds used [7,8], long-chain polyunsaturated fatty acids n-3 PUFA (eicosapentaenoic, EPA and docosahexaenoic, DHA) have shown promising results. N-3 PUFAs have been reported to modulate the expression of specific miRNAs [18,19,20]

Methods

Results

Conclusion