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Clin Nutr. 2016 Jun;35(3):578-86. doi: 10.1016/j.clnu.2015.05.001. Epub 2015 May 21.

Omega-3 polyunsaturated fatty acids in treating non-alcoholic steatohepatitis: A randomized, double-blind, placebo-controlled trial.

Author information

1
University of São Paulo School of Medicine, Department of Gastroenterology, Clinical Division of Clinical Gastroenterology and Hepatology (LIM-07), São Paulo, Brazil.
2
University of São Paulo School of Medicine, Department of Pathology (LIM-14), São Paulo, Brazil.
3
University of São Paulo School of Medicine, Department of Gastroenterology, Surgery Division (LIM-35), São Paulo, Brazil.
4
University of São Paulo School of Medicine, Department of Emergency (LIM-51), Sao Paulo, Brazil.
5
University of São Paulo School of Medicine, Department of Gastroenterology, Surgery Division (LIM-35), São Paulo, Brazil. Electronic address: dan@ganep.com.br.

Abstract

BACKGROUND:

& aims: Few clinical trials have addressed the potential benefits of omega-3 polyunsaturated fatty acids (PUFAs) on non-alcoholic steatohepatitis (NASH). We evaluated the effects of supplementation with omega-3 PUFAs from flaxseed and fish oils in patients with biopsy-proven NASH.

METHODS:

Patients received three capsules daily, each containing 0.315 g of omega-3 PUFAs (64% alpha-linolenic [ALA], 16% eicosapentaenoic [EPA], and 21% docosahexaenoic [DHA] acids; n-3 group, n = 27) or mineral oil (placebo group, n = 23). Liver biopsies were evaluated histopathologically by the NASH activity score (NAS). Plasma levels of omega-3 PUFAs were assessed as a marker of intake at baseline and after 6 months of treatment. Secondary endpoints included changes in plasma biochemical markers of lipid metabolism, inflammation, and liver function at baseline and after 3 and 6 months of treatment.

RESULTS:

At baseline, NAS was comparable between the groups (p = 0.98). After intervention with omega-3 PUFAs, plasma ALA and EPA levels increased (p ≤ 0.05). However in the placebo group, we also observed increased EPA and DHA (p ≤ 0.05), suggesting an off-protocol intake of PUFAs. NAS improvement/stabilization was correlated with increased ALA in the n-3 group (p = 0.02) and with increased EPA (p = 0.04) and DHA (p = 0.05) in the placebo group. Triglycerides were reduced after 3 months in the n-3 group compared to baseline (p = 0.01).

CONCLUSIONS:

In NASH patients, the supplementation of omega-3 PUFA from flaxseed and fish oils significantly impacts on plasma lipid profile of patients with NASH. Plasma increase of these PUFAs was associated with better liver histology. (ID 01992809).

KEYWORDS:

Alpha-linolenic acid; Docosahexaenoic acid; Eicosapentaenoic acid; Fish oil; Flaxseed oil; Nonalcoholic steatohepatitis

PMID:
26047766
DOI:
10.1016/j.clnu.2015.05.001
[Indexed for MEDLINE]

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