Discipline of Exercise and Sport Science, University of Sydney, Australia.
J Hepatol. 2012 Apr;56(4):944-51. doi: 10.1016/j.jhep.2011.08.018. Epub 2011 Oct 21.
Non-alcoholic fatty liver disease (NAFLD) is a frequent accompaniment of obesity and insulin resistance. With the prevalence approaching 85% in obese populations, new therapeutic approaches to manage NAFLD are warranted. A systematic search of the literature was conducted for studies pertaining to the effect of omega-3 polyunsaturated fatty acid (PUFA) supplementation on NAFLD in humans. Primary outcome measures were liver fat and liver function tests: alanine aminotransferase (ALT) and aspartate aminotransferase [1]. Data were pooled and meta-analyses conducted using a random effects model. Nine eligible studies, involving 355 individuals given either omega-3 PUFA or control treatment were included. Beneficial changes in liver fat favoured PUFA treatment (effect size=-0.97, 95% CI: -0.58 to -1.35, p<0.001). A benefit of PUFA vs. control was also observed for AST (effect size=-0.97, 95% CI: -0.13 to -1.82, p=0.02). There was a trend towards favouring PUFA treatment on ALT but this was not significant (effect size=-0.56, 95% CI: -1.16 to 0.03, p=0.06). Sub-analyses of only randomised control trials (RCTs) showed a significant benefit for PUFA vs. control on liver fat (effect size=-0.96, 95% CI: -0.43 to -1.48, p<0.001), but not for ALT (p=0.74) or AST (p=0.28). There was significant heterogeneity between studies. The pooled data suggest that omega-3 PUFA supplementation may decrease liver fat, however, the optimal dose is currently not known. Well designed RCTs which quantify the magnitude of effect of omega-3 PUFA supplementation on liver fat are needed.
非酒精性脂肪性肝病（NAFLD）是肥胖和胰岛素抵抗的常见伴随疾病。在肥胖人群中，其患病率接近 85%，因此需要新的治疗方法来治疗 NAFLD。系统地检索了有关ω-3 多不饱和脂肪酸（PUFA）补充剂对人类 NAFLD 影响的文献。主要的疗效评估指标是肝脏脂肪和肝功能测试：丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）[1]。对数据进行了汇总，并使用随机效应模型进行了荟萃分析。共有 9 项符合条件的研究，涉及 355 名接受 ω-3 PUFA 或对照治疗的患者。PUFA 治疗有利于肝脏脂肪的有益变化（效果大小=-0.97，95%CI：-0.58 至-1.35，p<0.001）。与对照组相比，PUFA 也显示出 AST 的益处（效果大小=-0.97，95%CI：-0.13 至-1.82，p=0.02）。尽管倾向于支持 PUFA 治疗，但 ALT 的效果并不显著（效果大小=-0.56，95%CI：-1.16 至 0.03，p=0.06）。仅对随机对照试验（RCT）的亚分析显示，与对照组相比，PUFA 对肝脏脂肪有显著的益处（效果大小=-0.96，95%CI：-0.43 至-1.48，p<0.001），但对 ALT（p=0.74）或 AST（p=0.28）则没有。研究之间存在显著的异质性。汇总数据表明，ω-3 PUFA 补充剂可能会减少肝脏脂肪，但是目前尚不清楚最佳剂量。需要进行精心设计的 RCT 来量化 ω-3 PUFA 补充剂对肝脏脂肪的影响程度。
