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Omega-3 polyunsaturated fatty acids in treating non-alcoholic steatohepatitis: A randomized, double-blind, placebo-controlled trial.
Clin Nutr 2016; 35(3):578-86CN

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).

Authors+Show Affiliations

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

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26047766

Citation

Nogueira, Monize Aydar, et al. "Omega-3 Polyunsaturated Fatty Acids in Treating Non-alcoholic Steatohepatitis: a Randomized, Double-blind, Placebo-controlled Trial." Clinical Nutrition (Edinburgh, Scotland), vol. 35, no. 3, 2016, pp. 578-86.
Nogueira MA, Oliveira CP, Ferreira Alves VA, et al. Omega-3 polyunsaturated fatty acids in treating non-alcoholic steatohepatitis: A randomized, double-blind, placebo-controlled trial. Clin Nutr. 2016;35(3):578-86.
Nogueira, M. A., Oliveira, C. P., Ferreira Alves, V. A., Stefano, J. T., Rodrigues, L. S., Torrinhas, R. S., ... Waitzberg, D. L. (2016). Omega-3 polyunsaturated fatty acids in treating non-alcoholic steatohepatitis: A randomized, double-blind, placebo-controlled trial. Clinical Nutrition (Edinburgh, Scotland), 35(3), pp. 578-86. doi:10.1016/j.clnu.2015.05.001.
Nogueira MA, et al. Omega-3 Polyunsaturated Fatty Acids in Treating Non-alcoholic Steatohepatitis: a Randomized, Double-blind, Placebo-controlled Trial. Clin Nutr. 2016;35(3):578-86. PubMed PMID: 26047766.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Omega-3 polyunsaturated fatty acids in treating non-alcoholic steatohepatitis: A randomized, double-blind, placebo-controlled trial. AU - Nogueira,Monize Aydar, AU - Oliveira,Claudia Pinto, AU - Ferreira Alves,Venâncio Avancini, AU - Stefano,José Tadeu, AU - Rodrigues,Lívia Samara Dos Reis, AU - Torrinhas,Raquel Susana, AU - Cogliati,Bruno, AU - Barbeiro,Hermes, AU - Carrilho,Flair José, AU - Waitzberg,Dan Linetzky, Y1 - 2015/05/21/ PY - 2014/09/23/received PY - 2015/03/27/revised PY - 2015/05/08/accepted PY - 2015/6/7/entrez PY - 2015/6/7/pubmed PY - 2018/1/18/medline KW - Alpha-linolenic acid KW - Docosahexaenoic acid KW - Eicosapentaenoic acid KW - Fish oil KW - Flaxseed oil KW - Nonalcoholic steatohepatitis SP - 578 EP - 86 JF - Clinical nutrition (Edinburgh, Scotland) JO - Clin Nutr VL - 35 IS - 3 N2 - 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). SN - 1532-1983 UR - https://www.unboundmedicine.com/medline/citation/26047766/Omega_3_polyunsaturated_fatty_acids_in_treating_non_alcoholic_steatohepatitis:_A_randomized_double_blind_placebo_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0261-5614(15)00131-4 DB - PRIME DP - Unbound Medicine ER -