Hegazy Mona A, Ahmed Safaa M, Sultan Shaimaa M, Afifi Osama F, Mohamed Manal A, Azab Alshimaa E, Hassanen Mohamed A, Zaben Rakan K
Department of Internal Medicine, Kasr Aliny Hospital, Faculty of Medicine, Cairo University, Cairo 12556, Egypt.
Department of Neonatology, Mounira General Hospital, Cairo 4262130, Egypt.
World J Hepatol. 2025 Mar 27;17(3):102286. doi: 10.4254/wjh.v17.i3.102286.
Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide. Its prevalence is closely linked to the dramatic rise in obesity and non-communicable diseases. MASLD exhibits a progressive trajectory that may culminate in development of hepatic cirrhosis, thereby predisposing affected individuals to an elevated likelihood of hepatocarcinogenesis. Diet, especially dietary fatty acids, serves as a key link between nutrient intake and MASLD pathogenesis.
To explore the impact of various omega-6 fatty acid subtypes on the pathogenesis and therapeutic strategies of MASLD.
A systematic literature search was conducted across Web of Science, PubMed, Cochrane Central, Scopus, and Embase databases from inception through June 2024 to identify all original studies linking different subtypes of omega-6 polyunsaturated fatty acids to the pathogenesis and management of MASLD. The search strategy explored the linkage between omega-6 polyunsaturated fatty acids and their subtypes, including linoleic acid (LA), gamma-linolenic acid (GLA), arachidonic acid, conjugated LA, and docosapentaenoic acid, in relation to MASLD and cardiometabolic risk.
By employing the specified search strategy, a total of 83 articles were identified as potentially eligible. During the title, abstract, and full-text screening phases, 27 duplicate records were removed, leaving 56 records for relevance screening. Of these, 43 records were excluded for reasons such as irrelevance and language restrictions (limited to English), resulting in 13 full-text articles being included for detailed assessment (10 human studies,1 animal study, and 2 review articles). Although certain subtypes, as GLA, dihomo-GLA, omega-6-derived oxylipins, and most arachidonic acid-derived eicosanoids, exhibit pro-inflammatory effects, our findings suggest that other subtypes such as LA, cis-9, trans-11 conjugated LA, and docosapentaenoic acid have beneficial effects on fatty liver, cardiometabolic risk factors, and inflammation, even at high intake levels.
The varying health effects of omega-6 fatty acids, ranging from anti-inflammatory to pro-inflammatory impacts on the liver, leave the question of their recommendation for MASLD patients unresolved. This underscores the importance of careful selection when considering omega-6 supplementation.
代谢功能障碍相关脂肪性肝病（MASLD）是全球最常见的慢性肝病。其患病率与肥胖和非传染性疾病的急剧增加密切相关。MASLD呈现出一种渐进性病程，最终可能发展为肝硬化，从而使受影响个体患肝癌的可能性增加。饮食，尤其是膳食脂肪酸，是营养摄入与MASLD发病机制之间的关键环节。
探讨不同ω-6脂肪酸亚型对MASLD发病机制和治疗策略的影响。
从创刊至2024年6月，在Web of Science、PubMed、Cochrane Central、Scopus和Embase数据库中进行系统的文献检索，以识别所有将不同亚型的ω-6多不饱和脂肪酸与MASLD的发病机制和管理联系起来的原始研究。检索策略探讨了ω-6多不饱和脂肪酸及其亚型，包括亚油酸（LA）、γ-亚麻酸（GLA）、花生四烯酸、共轭亚油酸和二十二碳五烯酸，与MASLD和心脏代谢风险之间的联系。
通过采用指定的检索策略，共识别出83篇可能符合条件的文章。在标题、摘要和全文筛选阶段，删除了27条重复记录，留下56条记录进行相关性筛选。其中，43条记录因不相关和语言限制（仅限于英语）等原因被排除，最终纳入13篇全文文章进行详细评估（10项人体研究、1项动物研究和2篇综述文章）。尽管某些亚型，如GLA、二高-GLA、ω-6衍生的氧化脂质和大多数花生四烯酸衍生的类二十烷酸，具有促炎作用，但我们的研究结果表明，其他亚型，如LA、顺-9，反-11共轭亚油酸和二十二碳五烯酸，即使在高摄入量时，对脂肪肝、心脏代谢危险因素和炎症也有有益作用。
ω-6脂肪酸对肝脏的健康影响各不相同，从抗炎到促炎，这使得对于MASLD患者是否推荐使用ω-6脂肪酸的问题仍未得到解决。这凸显了在考虑补充ω-6脂肪酸时谨慎选择的重要性。
