Fourth Department of Internal MedicineFirst Faculty of Medicine and General University Hospital in PragueCharles UniversityPragueCzech Republic.
Department of Diagnostic and Interventional RadiologyInstitute for Clinical and Experimental MedicinePragueCzech Republic.
Hepatol Commun. 2022 Jun;6(6):1336-1349. doi: 10.1002/hep4.1906. Epub 2022 Feb 11.
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease. n-3 polyunsaturated fatty acids (n-3-PUFAs) have been reported to ameliorate the progression of NAFLD in experimental studies; however, clinical trials have yielded contradictory results. The aim of our study was to assess the effects of n-3-PUFA administration on lipid metabolism and the progression of NAFLD in patients with metabolic syndrome. Sixty patients with metabolic syndrome and NAFLD were randomized in a double-blind placebo-controlled trial (3.6 g/day n-3-PUFA vs. placebo). During the 1-year follow-up, the patients underwent periodic clinical and laboratory examinations, liver stiffness measurements, magnetic resonance spectroscopy of the liver, and plasma lipidomic analyses. After 12 months of n-3-PUFA administration, a significant decrease in serum GGT activity was recorded compared with the placebo group (2.03 ± 2.8 vs. 1.43 ± 1.6; P < 0.05). Although no significant changes in anthropometric parameters were recorded, a significant correlation between the reduction of liver fat after 12 months of treatment-and weight reduction-was observed; furthermore, this effect was clearly potentiated by n-3-PUFA treatment (P < 0.005). In addition, n-3-PUFA treatment resulted in substantial changes in the plasma lipidome, with n-3-PUFA-enriched triacylglycerols and phospholipids being the most expressed lipid signatures. Conclusion: Twelve months of n-3-PUFA treatment of patients with NAFLD patients was associated with a significant decrease in GGT activity, the liver fat reduction in those who reduced their weight, and beneficial changes in the plasma lipid profile.
非酒精性脂肪性肝病 (NAFLD) 是最常见的慢性肝病。研究报道,n-3 多不饱和脂肪酸 (n-3-PUFA) 可改善实验性 NAFLD 的进展;然而,临床试验得出了相互矛盾的结果。我们的研究旨在评估 n-3-PUFA 给药对代谢综合征患者脂质代谢和 NAFLD 进展的影响。60 例代谢综合征合并 NAFLD 的患者被随机分配到双盲安慰剂对照试验(n-3-PUFA 3.6 g/天 vs. 安慰剂)中。在 1 年的随访期间,患者接受了定期的临床和实验室检查、肝脏硬度测量、肝脏磁共振波谱和血浆脂质组学分析。与安慰剂组相比,n-3-PUFA 给药 12 个月后,血清 GGT 活性显著下降(2.03 ± 2.8 与 1.43 ± 1.6;P < 0.05)。尽管体重指数等人体测量参数没有明显变化,但在治疗 12 个月后肝脏脂肪减少与体重减轻之间观察到显著相关性;此外,n-3-PUFA 治疗明显增强了这种效果(P < 0.005)。此外,n-3-PUFA 治疗导致血浆脂质组发生实质性变化,n-3-PUFA 富集的三酰甘油和磷脂是表达最丰富的脂质特征。结论:12 个月的 n-3-PUFA 治疗 NAFLD 患者与 GGT 活性显著降低、体重减轻患者的肝脏脂肪减少以及血浆脂质谱的有益变化相关。