Highly purified eicosapentaenoic acid treatment improves nonalcoholic steatohepatitis
Highly purified eicosapentaenoic acid treatment improves nonalcoholic steatohepatitis
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DOI：
10.1097/mcg.0b013e31815591aa
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发表时间：
2008-04-01
影响因子：
2.9
通讯作者：
Aoyama, Toshifumi
中科院分区：
文献类型：
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作者：
Tanaka, Naoki;Sano, Kenji;Aoyama, Toshifumi
最近的研究表明，n-3多不饱和脂肪酸可以改善非酒精性脂肪性肝病。二十碳五烯酸(EPA)是n-3多不饱和脂肪酸的主要成分之一，被广泛用作降血脂药，但其对非酒精性脂肪性肝炎(NASH)的单一疗效尚不清楚。因此，我们的目标是在一项先导性试验中评估EPA对23名经活检证实的NASH患者的有效性和安全性。给予高纯度EPA(2700 mg/d)治疗12个月，通过生化指标和肝组织学评价疗效。所有患者都完成了治疗，没有不良反应，表明对治疗的耐受性可以接受。治疗12个月后，血清丙氨酸氨基转移酶水平明显改善(从79 36 U/L降至50 120 U/L)，血清游离脂肪酸、血浆可溶性肿瘤坏死因子受体1和2水平以及反映肝脏氧化应激的血清铁蛋白和硫氧还蛋白水平均显著下降。体重、血糖、胰岛素和脂联素浓度保持不变。23名患者中有7名患者同意接受治疗后的肝活检，其中6名患者的肝脏脂肪变性和纤维化、肝细胞肿胀和小叶炎得到改善。总而言之，EPA治疗NASH患者似乎是安全有效的，这主要是由于其抗炎和抗氧化特性。为了证实这些结果，需要进行适当的动力控制试验。
Recent studies have demonstrated that n-3 polyunsaturated fatty acids ameliorate nonalcoholic fatty liver disease. Although eicosapentaenoic acid (EPA), one of the major components of n-3 polyunsaturated fatty acids, is widely used as an antilipidemic agent, its single efficacy for nonalcoholic steatohepatitis (NASH) remains unclear. As such, we aimed to evaluate the efficacy and safety of EPA on 23 biopsy-proven NASH patients in a pilot trial. Highly purified EPA (2700 mg/d) was administered for 12 months and efficacy was assessed by biochemical parameters and liver histology. All patients completed the treatment with no adverse events, indicating acceptable tolerance to the treatment. After 12 months, serum alanine amino transferase levels were significantly improved (from 79 36 to 50 120 U/L), and serum free fatty acids, plasma soluble tumor necrosis factor receptor 1 and 2 levels, and serum ferritin and thioredoxin levels, which may reflect hepatic oxidative stress, were significantly decreased. Body weight, blood glucose, insulin, and adiponectin concentrations remained unchanged. Seven of the 23 patients consented to undergo posttreatment liver biopsy, which showed improvement of hepatic steatosis and fibrosis, hepatocyte ballooning, and lobular inflammation in 6 patients. In conclusion, EPA treatment seems to be safe and efficacious for patients with NASH, largely due to its anti-inflammatory and antioxidative properties. To confirm these results, appropriately powered, controlled trials are needed.