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Omega-3 fatty acids as a treatment for non-alcoholic fatty liver disease in children: A systematic review and meta-analysis of randomized controlled trials.
Clin Nutr 2018; 37(2):516-521CN

Abstract

BACKGROUND

The most typical chronic liver disease in children and adolescents is non-alcoholic fatty liver disease (NAFLD). The dietary addition of ω-3 polyunsaturated fatty acids (PUFAs) provides a promising therapy for children with NAFLD due to its convenience and safety; however, several studies suggested contradictory results for PUFA supplementation in children. Hence, we performed a systematic review and meta-analysis to evaluate the effectiveness of PUFA supplementation in children with NAFLD.

METHODS

Published randomized controlled trials (RCTs) that evaluated the effectiveness of the dietary addition of PUFA in children with NAFLD were considered. The primary result was the alteration in hepatic steatosis grade on ultrasound after treatment. The secondary outcomes included alanine aminotransferase (ALT), aspartate aminotransferase (AST), C-reactive protein (CRP) and components of metabolic syndrome. Predefined sensitivity analysis was also performed to explore possible explanations for heterogeneity in the evaluations.

RESULTS

In total, 4 studies with 263 subjects were identified. PUFA supplementation was associated with significantly improved hepatic steatosis grade on ultrasound (risk difference: 25%, 95% CI: 12-38%), without heterogeneity (P = 0.27, I2 = 24%). Sensitivity analysis confirmed the robustness of our findings. PUFA supplementation could decrease AST levels after 6 months, but could only reduce ALT levels after 12 months. PUFA did not have a significant effect on most components of metabolic syndrome and the CRP level.

CONCLUSION

ω-3 PUFA supplementation can improve liver steatosis and liver functions, and it is a potential food supplementation to treat NAFLD in children.

Authors+Show Affiliations

Department of Pediatrics, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.Department of Pediatrics, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China. Electronic address: pediatricsfe@gmail.com.Department of Pediatrics, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.Department of Intensive Care Unit, The First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, China.

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

Language

eng

PubMed ID

28040302

Citation

Chen, Lian-Hui, et al. "Omega-3 Fatty Acids as a Treatment for Non-alcoholic Fatty Liver Disease in Children: a Systematic Review and Meta-analysis of Randomized Controlled Trials." Clinical Nutrition (Edinburgh, Scotland), vol. 37, no. 2, 2018, pp. 516-521.
Chen LH, Wang YF, Xu QH, et al. Omega-3 fatty acids as a treatment for non-alcoholic fatty liver disease in children: A systematic review and meta-analysis of randomized controlled trials. Clin Nutr. 2018;37(2):516-521.
Chen, L. H., Wang, Y. F., Xu, Q. H., & Chen, S. S. (2018). Omega-3 fatty acids as a treatment for non-alcoholic fatty liver disease in children: A systematic review and meta-analysis of randomized controlled trials. Clinical Nutrition (Edinburgh, Scotland), 37(2), pp. 516-521. doi:10.1016/j.clnu.2016.12.009.
Chen LH, et al. Omega-3 Fatty Acids as a Treatment for Non-alcoholic Fatty Liver Disease in Children: a Systematic Review and Meta-analysis of Randomized Controlled Trials. Clin Nutr. 2018;37(2):516-521. PubMed PMID: 28040302.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Omega-3 fatty acids as a treatment for non-alcoholic fatty liver disease in children: A systematic review and meta-analysis of randomized controlled trials. AU - Chen,Lian-Hui, AU - Wang,Yong-Fen, AU - Xu,Qing-Hong, AU - Chen,Shan-Shan, Y1 - 2016/12/23/ PY - 2016/08/30/received PY - 2016/12/08/revised PY - 2016/12/09/accepted PY - 2017/1/4/pubmed PY - 2019/8/31/medline PY - 2017/1/2/entrez KW - Children KW - Fish oil KW - Non-alcoholic fatty liver disease KW - Obesity KW - Polyunsaturated fatty acids SP - 516 EP - 521 JF - Clinical nutrition (Edinburgh, Scotland) JO - Clin Nutr VL - 37 IS - 2 N2 - BACKGROUND: The most typical chronic liver disease in children and adolescents is non-alcoholic fatty liver disease (NAFLD). The dietary addition of ω-3 polyunsaturated fatty acids (PUFAs) provides a promising therapy for children with NAFLD due to its convenience and safety; however, several studies suggested contradictory results for PUFA supplementation in children. Hence, we performed a systematic review and meta-analysis to evaluate the effectiveness of PUFA supplementation in children with NAFLD. METHODS: Published randomized controlled trials (RCTs) that evaluated the effectiveness of the dietary addition of PUFA in children with NAFLD were considered. The primary result was the alteration in hepatic steatosis grade on ultrasound after treatment. The secondary outcomes included alanine aminotransferase (ALT), aspartate aminotransferase (AST), C-reactive protein (CRP) and components of metabolic syndrome. Predefined sensitivity analysis was also performed to explore possible explanations for heterogeneity in the evaluations. RESULTS: In total, 4 studies with 263 subjects were identified. PUFA supplementation was associated with significantly improved hepatic steatosis grade on ultrasound (risk difference: 25%, 95% CI: 12-38%), without heterogeneity (P = 0.27, I2 = 24%). Sensitivity analysis confirmed the robustness of our findings. PUFA supplementation could decrease AST levels after 6 months, but could only reduce ALT levels after 12 months. PUFA did not have a significant effect on most components of metabolic syndrome and the CRP level. CONCLUSION: ω-3 PUFA supplementation can improve liver steatosis and liver functions, and it is a potential food supplementation to treat NAFLD in children. SN - 1532-1983 UR - https://www.unboundmedicine.com/medline/citation/28040302/Omega_3_fatty_acids_as_a_treatment_for_non_alcoholic_fatty_liver_disease_in_children:_A_systematic_review_and_meta_analysis_of_randomized_controlled_trials_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0261-5614(16)31350-4 DB - PRIME DP - Unbound Medicine ER -