Department of Pediatrics, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
Department of Pediatrics, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
Clin Nutr. 2018 Apr;37(2):516-521. doi: 10.1016/j.clnu.2016.12.009. Epub 2016 Dec 23.
The most typical chronic liver disease in children and adolescents is non-alcoholic fatty liver disease (NAFLD). The dietary addition of ω-3 polyunsaturated fatty acids (PUFAs) provides a promising therapy for children with NAFLD due to its convenience and safety; however, several studies suggested contradictory results for PUFA supplementation in children. Hence, we performed a systematic review and meta-analysis to evaluate the effectiveness of PUFA supplementation in children with NAFLD.
Published randomized controlled trials (RCTs) that evaluated the effectiveness of the dietary addition of PUFA in children with NAFLD were considered. The primary result was the alteration in hepatic steatosis grade on ultrasound after treatment. The secondary outcomes included alanine aminotransferase (ALT), aspartate aminotransferase (AST), C-reactive protein (CRP) and components of metabolic syndrome. Predefined sensitivity analysis was also performed to explore possible explanations for heterogeneity in the evaluations.
In total, 4 studies with 263 subjects were identified. PUFA supplementation was associated with significantly improved hepatic steatosis grade on ultrasound (risk difference: 25%, 95% CI: 12-38%), without heterogeneity (P = 0.27, I = 24%). Sensitivity analysis confirmed the robustness of our findings. PUFA supplementation could decrease AST levels after 6 months, but could only reduce ALT levels after 12 months. PUFA did not have a significant effect on most components of metabolic syndrome and the CRP level.
ω-3 PUFA supplementation can improve liver steatosis and liver functions, and it is a potential food supplementation to treat NAFLD in children.
儿童和青少年中最常见的慢性肝病是非酒精性脂肪性肝病（NAFLD）。由于ω-3 多不饱和脂肪酸（PUFAs）的添加物具有方便和安全的特点，因此它为患有 NAFLD 的儿童提供了一种有前途的治疗方法；然而，几项研究表明，PUFA 补充剂对儿童的效果存在矛盾。因此，我们进行了系统评价和荟萃分析，以评估 PUFA 补充剂对患有 NAFLD 的儿童的有效性。
考虑了评估 PUFA 饮食添加对 NAFLD 儿童有效性的已发表随机对照试验（RCTs）。主要结果是治疗后超声检查肝脏脂肪变性程度的变化。次要结果包括丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、C 反应蛋白（CRP）和代谢综合征的成分。还进行了预先定义的敏感性分析，以探讨评估中异质性的可能解释。
总共确定了 4 项研究，共 263 名受试者。PUFA 补充与超声检查肝脏脂肪变性程度明显改善相关（风险差异：25%，95%CI：12-38%），无异质性（P=0.27，I=24%）。敏感性分析证实了我们研究结果的稳健性。PUFA 补充可在 6 个月后降低 AST 水平，但仅可在 12 个月后降低 ALT 水平。PUFA 对代谢综合征的大多数成分和 CRP 水平没有显著影响。
ω-3 PUFA 补充可以改善肝脏脂肪变性和肝功能，是治疗儿童 NAFLD 的一种潜在的食物补充剂。
