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Non-alcoholic fatty liver disease severity and metabolic complications in obese children: impact of omega-3 fatty acids
Institution:1. Research Centre, CHU Sainte-Justine, Université de Montreal, Montreal, Quebec, Canada;2. Department of Nutrition, Université de Montreal, Montreal, Quebec, Canada;3. Institute of Nutraceuticals and Functional foods, Université Laval, Quebec, Quebec, Canada;4. Department of Pediatrics, Université de Montreal, Montreal, Quebec, Canada;5. The Montreal Children''s Hospital, McGill University Health Centre, Montreal, Quebec;6. Department of Radiology, Université de Montreal, Montreal, Quebec, Canada;7. Centre de recherche Rhône-Alpes en nutrition humaine, Hôpital Edouard-Herriot, Faculté de Médicine, Université de Lyon-1, France;1. Department of Endocrinology and Metabolism, Shaoxing People’s Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, 312000, China;2. Medicine and Bioscience College, Zhejiang University City College, Hangzhou, 310000, China;3. School of Food Science and Engineering, Zhejiang University, Hangzhou, 312029, China;1. Division of Human Nutrition, Department of Food, Environmental and Nutritional Sciences, Università degli Studi di Milano, Milan, Italy;2. Department of Public Health and Pediatric Sciences, Università degli Studi di Torino, Turin, Italy
Abstract:Although n-3 polyunsaturated fatty acids (PUFA) revealed promising therapeutic results in non-alcoholic fatty liver disease (NAFLD), which is considered as the most prevalent cause of chronic hepatic disease, inconsistencies are calling for further confirmatory trials to demonstrate therapeutic efficacy and safety. The study, registered as NCT02201160 on www.clinicaltrials.gov, was designed to compare two groups of NAFLD with a different severity, and to evaluate the efficacy of n-3 PUFA supplementation. Twenty young male participants of French Canadian origin with NAFLD were enrolled and classified into moderate (mNAFLD) and severe (sNAFLD) fatty liver groups, according to transaminase levels, ultrasonography, NAFLD Activity Score and Fatty Liver Index (FLI). The sNAFLD patients were assigned to consume 2 g of n-3 PUFA for 6 months. sNAFLD patients displayed higher insulinemia, insulin resistance (IR), oxidative stress (OxS), systolic blood pressure and the risk lipid indicators of cardiovascular diseases. Supplementation of n-3 PUFA for 6 months resulted in a significant increase in concentrations of eicosapentaenoic and docosahexaenoic acids in red blood cells along with an attenuation of hepatic steatosis as reflected by the reduction of the FLI, ALT and ALT/AST ratio. Moreover, the n-3 PUFA improved the lipid profile and carotid intima-media thickness, while reducing metabolic and OxS markers as well as raising adiponectin. In conclusion, NAFLD severity was essentially related to IR. Treatment with n-3 PUFA has an evidently beneficial effect on liver steatosis and related metabolic abnormalities. Furthermore, the cross association of omega-3 index with cardiometabolic markers may serve as a predictor for cardiovascular risk disorders in NAFLD.
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