Effects of n-3 polyunsaturated fatty acids in subjects with nonalcoholic fatty liver disease

Spadaro, L.; Magliocco, O.; Spampinato, Daniela; Piro, Salvatore; Oliveri, Conchita Emanuela; Alagona, C.; Papa, G; Rabuazzo, Agata Maria; Purrello, Francesco

doi:10.1016/j.dld.2007.10.003

Cited by 258 publications

(217 citation statements)

References 28 publications

Supporting

Mentioning

191

Contrasting

Unclassified

Order By: Relevance

“…However, ultrasonography is a qualitative, operator-dependent technique and misses steatosis of lower grade (involving < 33 % hepatocytes), making it hard to compare ultrasonographic with MRS trails. [32][33][34][35] An improvement in hypertriglyceridemia and insulin resistance was also observed. Overall, PUFAs were well tolerated, with minor gastrointestinal symptoms.…”

Section: Insulin-sensitizers: Thiazolidinediones Vs Metformin or Vsmentioning

confidence: 82%

See 1 more Smart Citation

A Meta-Analysis of Randomized Trials for the Treatment of Nonalcoholic Fatty Liver Disease

Musso¹,

Gambino²,

Cassader³

et al. 2010

Hepatology

518

436

View full text Add to dashboard Cite

Nonalcoholic fatty liver disease (NAFLD) encompasses a histological spectrum ranging from simple steatosis to nonalcoholic steatohepatitis (NASH). NAFLD carries a higher risk of cardio-metabolic and liver-related complications, the latter being confined to NASH and demanding specific treatment. We assessed the efficacy of proposed treatments for NAFLD/NASH by reviewing reports of randomized controlled trials (RCTs) on online databases and national and international meeting abstracts through January 2010. Primary outcome measure was histological improvement; secondary outcome was biochemical improvement; improvement in radiological steatosis was also evaluated. Two reviewers extracted articles using predefined quality indicators, independently and in duplicate. Main outcomes of randomized controlled trials (RCTs) were pooled using random-effects or fixed-effects models. Publication bias was assessed by funnel plots. Forty-nine RCTs (30 in NASH) were included: 23 RCTs (22 in NASH, 1 in NAFLD) had post-treatment histology. Most RCTs were small and did not exceed 1-year duration. Weight loss, thiazolidinediones (especially pioglitazone), and antioxidants were most extensively evaluated. Weight loss was safe and dose-dependently improved histological disease activity in NASH, but more than 50% of patients failed to achieve target weight loss. Thiazolidinediones improved steatosis and inflammation but yielded significant weight gain. RCTs with antioxidants yielded conflicting results and were heterogeneous with respect to type and dose of drug, duration, implementation of lifestyle intervention. Among the other agents, pentoxifylline, telmisartan and L-carnitine improved liver histology in at least 1 RCT in NASH; polyunsaturated fatty acid (PUFA) ameliorated biochemical and radiological markers of NAFLD. Other approaches yielded negative results. Conclusion: Well-designed RCTs of adequate size and duration, with histological endpoints, are needed to assess long-term safety and efficacy of proposed treatments on patient-oriented clinical outcomes. (HEPATOLOGY 2010;52:79-104)

show abstract

Section: Insulin-sensitizers: Thiazolidinediones Vs Metformin or Vsmentioning

confidence: 82%

“…5). Steatosis by MRS 35 or ultrasonography 33,34 resolved in 20%-64% of cases. However, ultrasonography is a qualitative, operator-dependent technique and misses steatosis of lower grade (involving < 33 % hepatocytes), making it hard to compare ultrasonographic with MRS trails.…”

Section: Insulin-sensitizers: Thiazolidinediones Vs Metformin or Vsmentioning

confidence: 99%

A Meta-Analysis of Randomized Trials for the Treatment of Nonalcoholic Fatty Liver Disease

Musso¹,

Gambino²,

Cassader³

et al. 2010

Hepatology

518

436

View full text Add to dashboard Cite

show abstract

“…Small uncontrolled studies in patients with NAFLD reported a reduction in transaminase levels during treatment with omega-3 fatty acids [55,56] . In 2 controlled studies (n = 40 and 144, respectively), omega-3 fatty acids combined with diet reduced transaminase levels and hepatic fatty infiltration in ultrasound more than diet alone in patients with NAFLD [57,58] . In the only study that assessed the effects of omega-3 fatty acids on liver histology, treatment with the omega-3 fatty acid eicosipentanoic acid (EPA) for 12 mo reduced transaminase levels in 23 patients with NASH [59] .…”

Section: Omega-3 Fatty Acidsmentioning

confidence: 99%

Lipid-lowering agents in the management of nonalcoholic fatty liver disease

Τζιόμαλος¹

2014

WJH

View full text Add to dashboard Cite

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in developed countries and is associated not only with increased risk for liver disease-related complications but also with higher cardiovascular morbidity. Accordingly, lipid-lowering agents are frequently considered in these patients to reduce cardiovascular risk. However, there have been concerns regarding the safety of these agents in patients with chronic liver diseases. In the present review, we discuss the safety of lipid-lowering agents in patients with NAFLD as well as their effects on both cardiovascular and liver disease in this population. Accumulating data suggest that statins are safe in patients with NAFLD and that they reduce the increased cardiovascular morbidity of this population. However, it is still unclear whether statins are also useful as a treatment for NAFLD per se , since there are very limited and conflicting data on their effects on liver histology. There is also very scarce evidence regarding the safety and efficacy of other lipid-lowering agents in patients with NAFLD. Randomized controlled studies are needed to evaluate the role of lipid-lowering agents and particularly statins for the prevention of both cardiovascular and liver disease-related complications in this high-risk population. Core tip: Accumulating data suggest that statins are safe in patients with nonalcoholic fatty liver disease (NAFLD) and that they reduce the increased cardiovascular morbidity of this population. However, it is still unclear whether statins are also useful as a treatment for NAFLD per se , since there are very limited and conflicting data on their effects on liver histology. There is also very scarce evidence regarding the safety and efficacy of other lipid-lowering agents in patients with NAFLD.Tziomalos K. Lipid-lowering agents in the management of nonalcoholic fatty liver disease.

show abstract

“…4) and steatosis by NMR or ultrasound [65][66][67][68]. In the only RCT with post-treatment histology, PUFA ameliorated steatosis without affecting other histological features [68].…”

mentioning

confidence: 99%

“…n-3 polyunsaturated fatty acids Five RCTs (303 participants, two RCTs with low risk of bias) evaluated polyunsaturated fatty acids (PUFA) [64][65][66][67][68] (ESM Table 3). …”

mentioning

confidence: 99%

Impact of current treatments on liver disease, glucose metabolism and cardiovascular risk in non-alcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis of randomised trials

et al. 2012

View full text Add to dashboard Cite

Aims/hypothesis Non-alcoholic fatty liver disease (NAFLD) encompasses a spectrum ranging from simple steatosis to non-alcoholic steatohepatitis (NASH): NAFLD causes an increased risk of cardiovascular disease, diabetes and liverrelated complications (the latter confined to NASH). The effect of proposed treatments on liver disease, glucose metabolism and cardiovascular risk in NAFLD is unknown. We reviewed the evidence for the management of liver disease and cardiometabolic risk in NAFLD. Methods Publications through November 2011 were systematically reviewed by two authors. Outcomes evaluated though standard methods were: histological/radiological/biochemical features of NAFLD, variables of glucose metabolism and cardiovascular risk factors. Seventy-eight randomised trials were included (38 in NASH, 40 in NAFLD): 41% assessed post-treatment histology, 71% assessed glucose metabolism and 88% assessed cardiovascular risk factors. Lifestyle intervention, thiazolidinediones, metformin and antioxidants were most extensively evaluated. Results Lifestyle-induced weight loss was safe and improved cardio-metabolic risk profile; a weight loss ≥7% improved histological disease activity, but was achieved by <50%

show abstract

Effects of n-3 polyunsaturated fatty acids in subjects with nonalcoholic fatty liver disease

Cited by 258 publications

References 28 publications

A Meta-Analysis of Randomized Trials for the Treatment of Nonalcoholic Fatty Liver Disease

A Meta-Analysis of Randomized Trials for the Treatment of Nonalcoholic Fatty Liver Disease

Lipid-lowering agents in the management of nonalcoholic fatty liver disease

Impact of current treatments on liver disease, glucose metabolism and cardiovascular risk in non-alcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis of randomised trials

Contact Info

Product

Resources

About