Omega-3 fatty acids and nonalcoholic fatty liver disease in adults and children: where do we stand?
Omega-3 fatty acids and nonalcoholic fatty liver disease in adults and children: where do we stand?
复制标题
DOI：
10.1097/mco.0000000000000539
复制
发表时间：
2019-03
影响因子：
3.1
通讯作者：
Melinda H Spooner;D. Jump
中科院分区：
文献类型：
--
作者：
Melinda H Spooner;D. Jump
非酒精性脂肪性肝病（NAFLD）是世界范围内最常见的慢性脂肪性肝病。NAFLD的发病率与肥胖的患病率相似。此外，NAFLD可发展为非酒精性脂肪性肝炎（NASH）、肝硬化和原发性肝细胞癌（HCC）。因此，NAFLD已成为一个主要的公共卫生问题。我们讨论了最近的临床试验和荟萃分析，以评估C20-22 - 3多不饱和脂肪酸（PUFA）减轻成人和儿童先前存在的NAFLD的功效。NAFLD和NASH患者；和临床前NASH小鼠模型，肝脏饱和（SFA）和单不饱和（MUFA）脂肪丰度高，但肝脏C20-22 3 PUFA丰度低。肝脏脂肪类型和丰度的变化与肝脏脂肪毒性、炎症、氧化应激和纤维化有关。最近的荟萃分析和临床试验评估了c20 - 223pufa膳食补充剂改善已有NAFLD成人和儿童健康结局的能力。在NAFLD患者中，单独添加二十二碳六烯酸（DHA, 22:6,3）或添加二十碳五烯酸（EPA, 20:5,3）的饮食可耐受并有效降低肝脏脂肪。然而，关于C20-22 - 3 PUFA对更严重的NAFLD标志物（如肝损伤、炎症和纤维化）的衰减，结果喜忧参半。这些研究表明，饮食中补充C20-22 - 3 PUFA应被视为降低肥胖成人和NAFLD儿童肝脏脂肪的可行和有效的选择。
Purpose of review Nonalcoholic fatty liver disease (NAFLD) is the most common chronic fatty liver disease worldwide. The incidence of NAFLD parallels the prevalence of obesity. Moreover, NAFLD can progress to nonalcoholic steatohepatitis (NASH), cirrhosis and primary hepatocellular cancer (HCC). As such, NAFLD has become a major public health concern. We discuss recent clinical trials and meta-analyses evaluating the efficacy of C20-22 3 polyunsaturated fatty acids (PUFA) to attenuate preexisting NAFLD in adults and children. Recent findings Humans with NAFLD and NASH; and preclinical mouse models of NASH, have a high abundance of hepatic saturated (SFA) and monounsaturated (MUFA) fat, but a low abundance of hepatic C20-22 3 PUFA. This change in hepatic fat type and abundance is associated with hepatic lipotoxicity, inflammation, oxidative stress and fibrosis. Recent meta-analyses and clinical trials evaluated the capacity of C20-22 3 PUFA dietary supplementation to improve health outcomes in adults and children with preexisting NAFLD. Diets supplemented with docosahexaenoic acid (DHA, 22 : 6,3) alone or with eicosapentaenoic acid (EPA, 20 : 5,3) are tolerated and effective at lowering liver fat in NAFLD patients. However, outcomes are mixed with respect to C20-22 3 PUFA attenuation of more severe NAFLD markers, such as hepatic injury, inflammation and fibrosis. Summary These studies suggest that dietary supplementation with C20-22 3 PUFA should be considered as a viable and effective option to lower liver fat in obese adults and children with NAFLD.