Fish Oil Supplements Lower Serum Lipids and Glucose in Correlation with a Reduction in Plasma Fibroblast Growth Factor 21 and Prostaglandin E2 in Nonalcoholic Fatty Liver Disease Associated with Hyperlipidemia: A Randomized Clinical Trial

Abstract

Fish oil has been used effectively in the treatment of cardiovascular disease via triglyceride reduction and inflammation modulation. This study aimed to assess the effects of fish oil on patients with nonalcoholic fatty liver disease (NAFLD) associated with hyperlipidemia. Eighty participants with NAFLD associated with hyperlipidemia were randomly assigned to consume fish oil (n=40, 4 g/d) or corn oil capsules (n=40, 4 g/d) for 3 months in a double-blind, randomized clinical trial. Blood levels of lipids, glucose and insulin, liver enzymes, kidney parameters and cytokines at baseline and the end of the study were measured. Seventy people finished the trial. Plasma concentrations of eicosapentaenoic acid and docosahexaenoic acid significantly increased in the fish oil group after intervention. After adjustment for age, gender and BMI, fish oil significantly decreased fasting serum concentrations of total cholesterol, triglyceride, apolipoprotein B and glucose (by (mean±SD) 0.49±0.43 mmol/L, 0.58±0.89 mmol/L, 0.28±0.33 g/L and 0.76±0.56 mmol/L, respectively, P<0.05), as well as alanine aminotransferase and γ-glutamyl transpeptidase levels (by (median (interquartile)) 9.0(0.5, 21.5) and 7.0(2.2, 20.0) IU/L, respectively, P<0.05), significantly increased serum adiponectin levels (by 1.29±0.62 μg/mL, P<0.001), and reduced serum levels of tumor necrosis factor α, leukotrienes B4, fibroblast growth factor 21 (FGF21), cytokeratin 18 fragment M30 and prostaglandin E2 (by 1.70±1.18 pg/mL, 0.59±0.28 ng/mL, 121±31 pg/mL, 83±60 IU/L and 10.9±2.3 pg/mL, respectively, P<0.001). Corn oil had no effect except for increasing serum creatinine concentrations by 7.7±8.9 μmol/L (P=0.008). The effects of fish oil on lipids, glucose and γ-glutamyl transpeptidase were positively correlated with the reductions of serum FGF21 and prostaglandin E2 concentrations after adjustment for age, gender and BMI (r = 0.275 to 0.360 and 0.261 to 0.375, respectively, P<0.05). In conclusion, our findings suggest that fish oil can benefit metabolic abnormalities associated with NAFLD treatment.Trial Registration ChiCTR-TRC-12002380

A Novel Role of SIRT1/ FGF-21 in Taurine Protection Against Cafeteria Diet-Induced Steatohepatitis in Rats

“…Several clinical studies explained that the increased level of FGF-21, in patients with a cluster of obesity-related disorders including nonalcoholic fatty liver disease, is considered a compensatory, adaptive response to the induced proinflammatory milieu [47]. This is further evidenced by the significant positive correlation between FGF-21 and TNF-α in the current study.…”

Non-Alcoholic Fatty Liver Disease: Bases for Therapeutic Roles of Vitamin E and n-3 PUFA

“…[82][83][84] Hepatic enzymes such as ALT and AST decrease in the treated group compared to placebo one. [84][85][86] A diminish on plasma TG was also observed. 82,[84][85][86] Copyright: ©2017 Lizana et al Hodson et al 88 conducted a randomized control trial double-blind and placebo-controlled study.…”

“…[84][85][86] A diminish on plasma TG was also observed. 82,[84][85][86] Copyright: ©2017 Lizana et al Hodson et al 88 conducted a randomized control trial double-blind and placebo-controlled study. This was a pre-specified sub-study of the WELCOME trial (Wessex Evaluation of fatty Liver and Cardiovascular markers in NAFLD with OMacor therapy).…”

Nutritional regulation of fibroblast growth factor 21: from macronutrients to bioactive dietary compounds

“…The inclusion of the former in a diet for 3 months markedly reduces the circulating levels of FGF21 and other biomarkers, combined with decreases in serum lipids, glucose, liver enzymes, and other NAFLD risk factors. These results suggest that fish oil might contribute to reversing FGF21 resistance [152]. Regarding betaine, it is known that plasma betaine levels are reduced in insulin-resistant humans and that they correlate closely with insulin sensitivity.…”