The therapeutic potential of long-chain omega-3 fatty acids in nonalcoholic fatty liver disease.
OBJECTIVE
The pharmacologic approach to disease management has not (as of yet) demonstrated safety and efficacy in nonalcoholic fatty liver disease (NAFLD). The current article introduces the long-chain omega-3 polyunsaturated fatty acids (LC-ω3s), and reviews the evidence and mechanisms by which their increased intake or supplementation may ameliorate NAFLD.


METHODS
A literature search was performed through Ovid Medline, using such terms as NAFLD, NASH, nonalcoholic, steatosis, polyunsaturated fatty acids, fish oil and omega-3.


RESULTS
The LC-ω3s display pleiotropic properties that are of benefit in cardiovascular disease. Deficiency of omega-3 fatty acids results in hepatic steatosis, whereas fish oil displays powerful hypotriglyceridemic properties. Intake and/or metabolism of omega-3 fatty acids are commonly impaired in NAFLD patients. A number of pre-clinical and clinical studies have demonstrated an ameliorative effect of supplemental fish oil, seal oil and purified LC-ω3s in reducing hepatic lipid content in NAFLD. There is less evidence that hepatic inflammation and fibrosis are safely reduced by LC-ω3s.


CONCLUSIONS
Supplementation of LC-ω3s appears to safely reduce nutritional hepatic steatosis in adults. Whether other histopatholgic features of NAFLD also respond to LC-ω3s is being addressed by clinical trials. Any recommendation for omega-3 supplementation in NAFLD/NASH is contingent on these results.
Shapiro
Haim
H
The Institute for Nutrition Research, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel.
Tehilla
Miryam
M
Attal-Singer
Joelle
J
Bruck
Rafael
R
Luzzatti
Rachel
R
Singer
Pierre
P
D002986:Clinical Trials as Topic; D019587:Dietary Supplements; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005234:Fatty Liver / Q000188:drug therapy / Q000378:metabolism; D005395:Fish Oils / Q000627:therapeutic use*; D006801:Humans; D008099:Liver / Q000378:metabolism; D065626:Non-alcoholic Fatty Liver Disease; D009747:Nutritional Physiological Phenomena
D015525:Fatty Acids, Omega-3; D005395:Fish Oils