Effects of Omega-3 Fatty Acid in Nonalcoholic Fatty Liver Disease: A Meta-Analysis

Lu, Wenxia; Li, Sainan; Li, Jingjing; Wang, Jianrong; Zhang, Rong; Zhou, Yuqing; Yin, Qin; Zheng, Yuanyuan; Wang, Fan; Xia, Yujing; Chen, Kan; Liu, Tong; Lü, Jie; Zhou, Yingqun; Guo, Chuanyong

doi:10.1155/2016/1459790

Cited by 96 publications

(92 citation statements)

References 47 publications

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“…However, we also recommend including obeticholic acid in their guidelines considering the results from this meta-analysis. Lu et al 144 and He et al 145 observed beneficial effects in terms of reduction in the aminotransferase levels with PUFA and suggested as a treatment option for NAFLD from their meta-analysis. Although our results are in corroboration with these meta-analyses, we did not observe any significant changes in either the response rate or NAS.…”

Section: Discussionmentioning

confidence: 99%

Pharmacological interventions for non-alcoholic fatty liver disease: a systematic review and network meta-analysis

Sridharan

Sivaramakrishnan

Sequeira

et al. 2018

Postgraduate Medical Journal

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AimSeveral drugs have been used for treating non-alcoholic fatty liver disease (NAFLD). The present study is a network meta-analysis of such drugs.Design, setting and patientsRandomised clinical trials comparing drug interventions in patients with NAFLD were analysed. OR and weighted mean difference (95 % CI) were the effect estimates for categorical and numerical outcomes, respectively. Random-effects model was used to generate pooled estimates. Surface under the cumulative ranking curve was used to rank the treatments.Main outcome measuresProportion of responders was the primary outcome measure and non-alcoholic steatohepatitis scores, liver enzymes, lipid profile, body mass index, homeostatic model assessment of insulin resistance, intrahepatic fat and adverse events were the key secondary outcomes.Results116 studies were included in the systematic review and 106 in the meta-analysis. Elafibranor, gemfibrozil, metadoxine, obeticholic acid, pentoxifylline, pioglitazone, probiotics, telmisartan, vildagliptin and vitamin E significantly increased the response rate than standard of care. Various other drugs were observed to modify the secondary outcomes favourably. Probiotics was found with a better response in children; and elafibranor, obeticholic acid, pentoxifylline and pioglitazone in patients with type 2 diabetes mellitus. The quality of evidence observed was either low or very low.ConclusionIn patients with NAFLD, several drugs have been shown to have variable therapeutic benefit. However, the estimates and the inferences should be considered with extreme caution as it might change with the advent of future head-to-head clinical trials.

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Section: Discussionmentioning

confidence: 99%

Pharmacological interventions for non-alcoholic fatty liver disease: a systematic review and network meta-analysis

Sridharan

Sivaramakrishnan

Sequeira

et al. 2018

Postgraduate Medical Journal

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“…Our previous study showed that hepatic content of triglycerides was decreased by the downregulation of hepatic triglyceride synthesis and the upregulation of hepatic triglyceride oxidation in rats fed n-3 PUFA [34]. In addition, meta-analysis of randomized controlled trials showed that n-3 PUFA supplementation improved liver steatosis and liver function in patients with NAFLD [13,14,15]. This study also showed that erythrocyte levels of n-3 PUFA, 20:5n3, and 22:5n3 and the Omega-3 Index were lower in patients with NAFLD and negatively associated with the risk of NAFLD.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, Elizondo et al [12] showed that the erythrocyte level of n-3 PUFA, a marker for fish intake, was significantly lower in patients with NAFLD than healthy controls. Recent meta-analysis of randomized controlled trials consistently reported that n-3 PUFA supplementation could be a practical and effective treatment for NAFLD [13,14,15]. …”

Section: Introductionmentioning

confidence: 99%

Association of Blood Fatty Acid Composition and Dietary Pattern with the Risk of Non-Alcoholic Fatty Liver Disease in Patients Who Underwent Cholecystectomy

Shim¹,

Choi²,

Park³

2017

Ann Nutr Metab

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Background/Aims: The relationship between diet and non-alcoholic fatty liver disease (NAFLD) in patients with gallstone disease and in those who have a high risk for NAFLD has not been investigated. This study was conducted to investigate the association between the risk of NAFLD and dietary pattern in patients who underwent cholecystectomy. Additionally, we assessed the association between erythrocyte fatty acid composition, a marker for diet, and the risk of NAFLD. Methods: Patients (n = 139) underwent liver ultrasonography to determine the presence of NAFLD before laparoscopic cholecystectomy, reported dietary intake using food frequency questionnaire, and were assessed for blood fatty acid composition. Results: Fifty-eight patients were diagnosed with NAFLD. The risk of NAFLD was negatively associated with 2 dietary patterns: consuming whole grain and legumes and consuming fish, vegetables, and fruit. NAFLD was positively associated with the consumption of refined grain, meat, processed meat, and fried foods. Additionally, the risk of NAFLD was positively associated with erythrocyte levels of 16:0 and 18:2t, while it was negatively associated with 20:5n3, 22:5n3, and Omega-3 Index. Conclusion: The risk of NAFLD was negatively associated with a healthy dietary pattern of consuming whole grains, legumes, vegetables, fish, and fruit and with an erythrocyte level of n-3 polyunsaturated fatty acids rich in fish.

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“…Indeed, epidemiological studies implicated a lower consumption of omega‐3 PUFA and a higher n‐6/n‐3 ratio among NAFLD and NASH patients compared to controls . In a meta‐analysis of 10 RCTs, omega‐3 PUFA treatment was beneficial in terms of decreased amount of liver fat observed on US and improved gamma‐glutamyl transferase (GGT), but it was not significantly efficient in reduction of ALT and aspartate aminotransferase (AST) . Recent RCTs assessed the effect on NASH and fibrosis, yielding positive results with regard to liver fat reduction and disappointing results with regard to NASH or fibrosis .…”

Section: The Association Between Individual Components Of the MD And mentioning

confidence: 99%

The Mediterranean dietary pattern as the diet of choice for non‐alcoholic fatty liver disease: Evidence and plausible mechanisms

Zelber‐Sagi

Salomone²,

Mlynarsky

2017

Liver International

209

162

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Non-alcoholic fatty liver disease (NAFLD) has become a major global health burden, leading to increased risk for cirrhosis, hepatocellular carcinoma, type-2 diabetes and cardiovascular disease. Lifestyle intervention aiming at weight reduction is the most established treatment. However, changing the dietary composition even without weight loss can also reduce steatosis and improve metabolic alterations as insulin resistance and lipid profile. The Mediterranean diet (MD) pattern has been proposed as appropriate for this goal, and was recommended as the diet of choice for the treatment of NAFLD by the EASL-EASD-EASO Clinical Practice Guidelines. The MD has an established superiority in long term weight reduction over low fat diet, but it improves metabolic status and steatosis even without it.However, the effect on liver inflammation and fibrosis was tested only in few observational studies with positive results. Furthermore, considering the strong association between NAFLD and diabetes and CVD, the MD has a highly established advantage in prevention of these diseases, demonstrated in randomized clinical trials. The individual components of the MD such as olive oil, fish, nuts, whole grains, fruits, and vegetables, have been shown to beneficially effect or negatively correlate with NAFLD, while consumption of components that characterize a Western dietary pattern as soft drinks, fructose, meat and saturated fatty acids have been shown to have detrimental association with NAFLD. In this review we will cover the epidemiological evidence and the plausible molecular mechanisms by which the MD as a whole and each of its components can be of benefit in NAFLD.

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Effects of Omega-3 Fatty Acid in Nonalcoholic Fatty Liver Disease: A Meta-Analysis

Cited by 96 publications

References 47 publications

Pharmacological interventions for non-alcoholic fatty liver disease: a systematic review and network meta-analysis

Pharmacological interventions for non-alcoholic fatty liver disease: a systematic review and network meta-analysis

Association of Blood Fatty Acid Composition and Dietary Pattern with the Risk of Non-Alcoholic Fatty Liver Disease in Patients Who Underwent Cholecystectomy

The Mediterranean dietary pattern as the diet of choice for non‐alcoholic fatty liver disease: Evidence and plausible mechanisms

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