Tags

Type your tag names separated by a space and hit enter

Omega-3 fatty acids and non-alcoholic fatty liver disease: Evidence of efficacy and mechanism of action.
Mol Aspects Med 2018; 64:135-146MA

Abstract

For many years it has been known that high doses of long chain omega-3 fatty acids are beneficial in the treatment of hypertriglyceridaemia. Over the last three decades, there has also been a wealth of in vitro and in vivo data that has accumulated to suggest that long chain omega-3 fatty acid treatment might be beneficial to decrease liver triacylglycerol. Several biological mechanisms have been identified that support this hypothesis; notably, it has been shown that long chain omega-3 fatty acids have a beneficial effect: a) on bioactive metabolites involved in inflammatory pathways, and b) on alteration of nuclear transcription factor activities such as peroxisome proliferator-activated receptors (PPARs), sterol regulatory element-binding protein 1c (SREBP-1c) and carbohydrate-responsive element-binding protein (ChREBP), involved in inflammatory pathways and liver lipid metabolism. Since the pathogenesis of non alcoholic fatty liver disease (NAFLD) begins with the accumulation of liver lipid and progresses with inflammation and then several years later with development of fibrosis; it has been thought in patients with NAFLD omega-3 fatty acid treatment would be beneficial in treating liver lipid and possibly also in ameliorating inflammation. Meta-analyses (of predominantly dietary studies and small trials) have tended to support the assertion that omega-3 fatty acids are beneficial in decreasing liver lipid, but recent randomised controlled trials have produced conflicting data. These trials have suggested that omega-3 fatty acid might be beneficial in decreasing liver triglyceride (docosahexanoic acid also possibly being more effective than eicosapentanoic acid) but not in decreasing other features of steatohepatitis (or liver fibrosis). The purpose of this review is to discuss recent evidence regarding biological mechanisms by which long chain omega-3 fatty acids might act to ameliorate liver disease in NAFLD; to consider the recent evidence from randomised trials in both adults and children with NAFLD; and finally to discuss key 'known unknowns' that need to be considered, before planning future studies that are focussed on testing the effects of omega-3 fatty acid treatment in patients with NAFLD.

Authors+Show Affiliations

Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research, Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. Electronic address: e.scorletti@soton.ac.uk.Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research, Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.

Pub Type(s)

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

Language

eng

PubMed ID

29544992

Citation

Scorletti, Eleonora, and Christopher D. Byrne. "Omega-3 Fatty Acids and Non-alcoholic Fatty Liver Disease: Evidence of Efficacy and Mechanism of Action." Molecular Aspects of Medicine, vol. 64, 2018, pp. 135-146.
Scorletti E, Byrne CD. Omega-3 fatty acids and non-alcoholic fatty liver disease: Evidence of efficacy and mechanism of action. Mol Aspects Med. 2018;64:135-146.
Scorletti, E., & Byrne, C. D. (2018). Omega-3 fatty acids and non-alcoholic fatty liver disease: Evidence of efficacy and mechanism of action. Molecular Aspects of Medicine, 64, pp. 135-146. doi:10.1016/j.mam.2018.03.001.
Scorletti E, Byrne CD. Omega-3 Fatty Acids and Non-alcoholic Fatty Liver Disease: Evidence of Efficacy and Mechanism of Action. Mol Aspects Med. 2018;64:135-146. PubMed PMID: 29544992.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Omega-3 fatty acids and non-alcoholic fatty liver disease: Evidence of efficacy and mechanism of action. AU - Scorletti,Eleonora, AU - Byrne,Christopher D, Y1 - 2018/03/22/ PY - 2018/01/14/received PY - 2018/03/07/revised PY - 2018/03/09/accepted PY - 2018/3/17/pubmed PY - 2019/6/30/medline PY - 2018/3/17/entrez KW - Docosahexanoic acid KW - Eicosapentanoic acid KW - Fatty liver KW - Liver fibrosis KW - NAFLD KW - Non-alcoholic fatty liver disease KW - Nutrition KW - Omega-3 fatty acids KW - n-3 fatty acids SP - 135 EP - 146 JF - Molecular aspects of medicine JO - Mol. Aspects Med. VL - 64 N2 - For many years it has been known that high doses of long chain omega-3 fatty acids are beneficial in the treatment of hypertriglyceridaemia. Over the last three decades, there has also been a wealth of in vitro and in vivo data that has accumulated to suggest that long chain omega-3 fatty acid treatment might be beneficial to decrease liver triacylglycerol. Several biological mechanisms have been identified that support this hypothesis; notably, it has been shown that long chain omega-3 fatty acids have a beneficial effect: a) on bioactive metabolites involved in inflammatory pathways, and b) on alteration of nuclear transcription factor activities such as peroxisome proliferator-activated receptors (PPARs), sterol regulatory element-binding protein 1c (SREBP-1c) and carbohydrate-responsive element-binding protein (ChREBP), involved in inflammatory pathways and liver lipid metabolism. Since the pathogenesis of non alcoholic fatty liver disease (NAFLD) begins with the accumulation of liver lipid and progresses with inflammation and then several years later with development of fibrosis; it has been thought in patients with NAFLD omega-3 fatty acid treatment would be beneficial in treating liver lipid and possibly also in ameliorating inflammation. Meta-analyses (of predominantly dietary studies and small trials) have tended to support the assertion that omega-3 fatty acids are beneficial in decreasing liver lipid, but recent randomised controlled trials have produced conflicting data. These trials have suggested that omega-3 fatty acid might be beneficial in decreasing liver triglyceride (docosahexanoic acid also possibly being more effective than eicosapentanoic acid) but not in decreasing other features of steatohepatitis (or liver fibrosis). The purpose of this review is to discuss recent evidence regarding biological mechanisms by which long chain omega-3 fatty acids might act to ameliorate liver disease in NAFLD; to consider the recent evidence from randomised trials in both adults and children with NAFLD; and finally to discuss key 'known unknowns' that need to be considered, before planning future studies that are focussed on testing the effects of omega-3 fatty acid treatment in patients with NAFLD. SN - 1872-9452 UR - https://www.unboundmedicine.com/medline/citation/29544992/Omega_3_fatty_acids_and_non_alcoholic_fatty_liver_disease:_Evidence_of_efficacy_and_mechanism_of_action_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0098-2997(18)30019-0 DB - PRIME DP - Unbound Medicine ER -