Treatment of Nonalcoholic Fatty Liver Disease with Long-Chain n-3 Polyunsaturated Fatty Acids in Humans

Abstract

n-3 PUFA decreased several markers of NAFLD; however, there was a lower observed efficacy in NASH treatment. Further long-term placebo-controlled studies with adequate power and supplementation duration and standardized and sensitive detection methods are needed to determine the efficacy of EPA and DHA individually and in a mixture to treat NAFLD and NASH.

Impact of the Co-Administration of N-3 Fatty Acids and Olive Oil Components in Preclinical Nonalcoholic Fatty Liver Disease Models: A Mechanistic View

“…The preclinical studies discussed in this review suggest that the combined supplementation with natural products, including EPA and DHA, DHA and EVOO, or EPA plus HT, has a positive impact on NAFLD by diminishing hepatic fat deposition ( Figure 1C) and the development of a proinflammatory state by HFD [34][35][36][37][38][39][40], with DHA and HT co-administration preventing liver steatosis development completely ( Figure 1D) [56]. Although interventions with joined DHA and HT in human NAFLD are not available at present time, most, but not all, trials with n-3 LCPUFA show improvement in hepatic lipid deposition in adult and paediatric NAFLD patients within a 1 to 2 year time period, without diminution or exacerbation of NASH [54,82,83], DHA being more potent than EPA regarding the suppression of hepatic lipogenesis [84]. In relation to HT, (i) a study in healthy volunteers revealed that a dose of 15 mg/day for 3 weeks exerted positive effects on human health by diminishing parameters related to oxidative stress, with improvement in lipid and plasma profile [85]; (ii) a combined HT and vitamin E protocol improved hepatic steatosis and oxidative stress in children with NAFLD [86]; whereas (iii) the plasma levels of tissue inhibitor of metalloproteinases 1 (TIMP-1) in the group of patients receiving HT (15 mg/day for 63 days) were significantly lower than those levels found in the control group after the epirubicin-cyclophosphamide chemotherapy [87].…”

Emerging Noninvasive Biomarkers, and Medical Management Strategies for Alcoholic Hepatitis: Present Understanding and Scope

“…Animal model have shown that alcohol-fed mice have altered levels of resolvins [118] along with the changes in EPA and DHA levels. Use of DHA and EPA in improving liver injury in non-alcoholic fatty liver disease (NAFLD) is already being studied [119]; future research may show the benefits in ALD. Preliminary data has shown improvement in liver injury by supplementation of resolvin D1 to mice [58,120].…”

Flaxseed oil in the context of a weight loss programme ameliorates fatty liver grade in patients with non-alcoholic fatty liver disease: a randomised double-blind controlled trial

“…Among unsaturated fatty acids, n-3 fatty acids are advantageous for the liver due to the regulation of hepatic lipid metabolism and prevention of inflammation, as reviewed by Scorletti & Byrne (10) . According to animal and human studies, long-chain n-3 fatty acids present in fish reduce hepatic fat accumulation and liver enzyme levels, improve insulin sensitivity and decrease markers of inflammation, ballooning and fibrosis (11,12) . In addition, these fatty acids compete with n-6 fatty acids in the pathways that lead to the production of relevant eicosanoids (13) .…”