ω-3不饱和脂肪酸对非酒精性脂肪性肝病的影响：一项随机对照试验的系统评价和荟萃分析
The effect of omega-3 unsaturated fatty acids on non-alcoholic fatty liver disease: A systematic review and meta-analysis of RCTs.
作者信息
Yu Le, Yuan Man, Wang Linchun
机构信息
Dr. Le Yu, Center of Infectious Diseases, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu, 610041, Sichuan, China. Division of Infectious Diseases, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center for Biotherapy, Chengdu, Sichuan, China.
Dr. Man Yuan, Center of Infectious Diseases, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu, 610041, Sichuan, China. Division of Infectious Diseases, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center for Biotherapy, Chengdu, Sichuan, China.
出版信息
Pak J Med Sci. 2017 Jul-Aug;33(4):1022-1028. doi: 10.12669/pjms.334.12315.
OBJECTIVE
During the treatment of diseases such as angiocardiopathy, blood lipid abnormalities and metabolic syndrome, omega-3 unsaturated fatty acids (PUFA) can reduce plasma lipids and improve cardiovascular status, thus ameliorating disease severity. We aimed to explore the effects of PUFA supplementation in patients with non-alcoholic fatty liver disease (NAFLD).
METHODS
A systematic literature search was performed during March 2016 for randomized controlled trials using PUFA or fish oil supplementation in patients with NAFLD or non-alcoholic steatohepatitis (NASH). All Randomized controlled trials were retrieved from MEDLINE and EMBASE database up to date (March 2016). A meta-analysis of key outcomes (serum level of liver enzymes and lipids) were identified in these studies. The mean difference (MD) and the corresponding 95% confidence intervals (CIs) were used as measures of effect size.
RESULTS
Thirteen studies were included, consisting of 266 patients in the PUFA group and 402 cases in the control group. Serum level of alanine aminotransferase (ALT) was lower in the PUFA group than that in in the controls [MD=-9.18, 95% CI (-12.41, -5.96), <0.00001]. However, PUFA treatment did not affect aspartate aminotransferase (AST) [MD=-5.07, 95% CI (-12.65, 2.51), P= 0.19], gamma-glutamyl transferase (GGT) [MD=-1.91, 95% CI (-4.15, 0.33), <0.009].
CONCLUSIONS
PUFA supplementation may affects serum level of ALT and improve liver function in patients with NAFLD.
目的
在治疗心血管疾病、血脂异常和代谢综合征等疾病过程中，ω-3多不饱和脂肪酸（PUFA）可降低血脂并改善心血管状况，从而减轻疾病严重程度。我们旨在探讨补充PUFA对非酒精性脂肪性肝病（NAFLD）患者的影响。
方法
2016年3月进行了一项系统的文献检索，以查找在NAFLD或非酒精性脂肪性肝炎（NASH）患者中使用PUFA或鱼油补充剂的随机对照试验。截至2016年3月，所有随机对照试验均从MEDLINE和EMBASE数据库中检索。在这些研究中确定了关键结局（肝酶和血脂的血清水平）的荟萃分析。平均差异（MD）和相应的95%置信区间（CIs）用作效应大小的度量。
结果
纳入13项研究，PUFA组有266例患者，对照组有402例。PUFA组的血清丙氨酸氨基转移酶（ALT）水平低于对照组[MD=-9.18，95%CI（-12.41，-5.96），<0.00001]。然而，PUFA治疗对天冬氨酸氨基转移酶（AST）[MD=-5.07，95%CI（-12.65，2.51），P=0.19]、γ-谷氨酰转移酶（GGT）[MD=-1.91，95%CI（-4.15，0.33），<0.009]没有影响。
结论
补充PUFA可能会影响NAFLD患者的血清ALT水平并改善肝功能。
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