Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Road, Guangzhou, 510080, China.
Eur J Nutr. 2020 Apr;59(3):941-951. doi: 10.1007/s00394-019-01953-2. Epub 2019 Apr 1.
Previous studies have shown that high-dose supplementation with n-3 polyunsaturated fatty acids (PUFAs) may benefit patients with nonalcoholic fatty liver disease (NAFLD), but the association of n-3 PUFAs with NAFLD among individuals with normal diets is only speculative. We investigated the cross-sectional and prospective associations between n-3 PUFAs and NAFLD in Chinese adults.
This community-based prospective study included 3049 men and women (40-75 years) in Guangzhou, China, whose participants completed an NAFLD ultrasound evaluation and erythrocyte PUFA tests. A total of 2660 participants underwent the second NAFLD evaluation approximately 3 years later. α-Linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in erythrocytes were measured by gas chromatography.
After adjusting for potential confounders, we observed inverse associations between DHA, DHA + EPA, total n-3 PUFAs and the presence of NAFLD in the cross-sectional analysis. The adjusted odds ratios (95% confidence interval) of NAFLD for the highest (vs. lowest) tertile were 0.74 (0.61, 0.90) for DHA, 0.82 (0.67, 1.00) for EPA, 0.73 (0.60, 0.88) for DHA + EPA and 0.74 (0.61, 0.91) for total n-3 PUFAs (all P values≤0.05). Over the average 3.12 years of follow-up, higher levels of DHA was associated with an improvement of NAFLD. The hazard ratio of improved NAFLD for the highest tertile was 1.18 (95% CI 1.09, 1.33) for DHA. Pathway analyses showed that favorable associations may be mediated by improvements in inflammatory markers (e.g., interleukin 1 beta and tumor necrosis factor alpha-like).
Erythrocyte membrane n-3 PUFAs are inversely associated with the presence and progression of NAFLD in Chinese adults.
ClinicalTrials.gov NCT03179657.
既往研究表明，高剂量补充 n-3 多不饱和脂肪酸（PUFA）可能有益于非酒精性脂肪性肝病（NAFLD）患者，但在饮食正常的个体中，n-3 PUFA 与 NAFLD 的关联仍存在推测性。本研究旨在探讨中国成年人中 n-3 PUFA 与 NAFLD 的横断面和前瞻性关联。
本项基于社区的前瞻性研究纳入了中国广州的 3049 名 40-75 岁的男性和女性参与者，他们完成了 NAFLD 超声评估和红细胞 PUFA 检测。大约 3 年后，共有 2660 名参与者接受了第二次 NAFLD 评估。采用气相色谱法测定红细胞中的 α-亚麻酸（ALA）、二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）。
在调整了潜在混杂因素后，我们在横断面分析中观察到 DHA、DHA+EPA、总 n-3 PUFA 与 NAFLD 之间呈负相关。NAFLD 的最高（vs. 最低）三分位组的调整比值比（95%置信区间）为 DHA（0.74，0.61，0.90）、EPA（0.82，0.67，1.00）、DHA+EPA（0.73，0.60，0.88）和总 n-3 PUFA（0.74，0.61，0.91）（所有 P 值均≤0.05）。在平均 3.12 年的随访期间，较高水平的 DHA 与 NAFLD 的改善相关。DHA 最高三分位组的 NAFLD 改善的风险比为 1.18（95%CI 1.09，1.33）。通路分析表明，有利的关联可能通过改善炎症标志物（如白细胞介素 1β和肿瘤坏死因子α样）介导。
中国成年人红细胞膜 n-3 PUFA 与 NAFLD 的发生和进展呈负相关。
ClinicalTrials.gov NCT03179657。
