title: Omega-3 fatty acids for the treatment of non-alcoholic fatty liver disease.
abstract: Non-alcoholic fatty liver disease (NAFLD) has been recognized as a major health burden. It is the most important cause of chronic liver disease and a major independent cardiovascular risk factor. Lacking a definite treatment for NAFLD, a specific diet and an increase in physical activity represent the most commonly used therapeutic approaches. In this review, major literature data about the use of omega-3 polyunsaturated fatty acids (n-3 PUFAs) as a potential treatment of NAFLD have been described. n-3 PUFAs, besides having a beneficial impact on most of the cardio-metabolic risk factors (hypertension, hyperlipidemia, endothelial dysfunction and atherosclerosis) by regulating gene transcription factors [i.e., peroxisome proliferator-activated receptor (PPAR) α, PPARγ, sterol regulatory element-binding protein-1, carbohydrate responsive element-binding protein], impacts both lipid metabolism and on insulin sensitivity. In addition to an enhancement of hepatic beta oxidation and a decrease of the endogenous lipid production, n-3 PUFAs are able to determine a significant reduction of the expression of pro-inflammatory molecules (tumor necrosis factor-α and interleukin-6) and of oxygen reactive species. Further strengthening the results of the in vitro studies, both animal models and human intervention trials, showed a beneficial effect of n-3 PUFAs on the severity of NAFLD as expressed by laboratory parameters and imaging measurements. Despite available results provided encouraging data about the efficacy of n-3 PUFAs as a treatment of NAFLD in humans, well-designed randomized controlled trials of adequate size and duration, with histological endpoints, are needed to assess the long-term safety and efficacy of PUFA, as well as other therapies, for the treatment of NAFLD and non-alcoholic steatohepatitis patients. It is worthwhile to consider that n-3 PUFAs cannot be synthesized by the human body and must be derived from exogenous sources (fish oil, flaxseeds, olive oil) which are typical foods of the Mediterranean diet, known for its beneficial effects in preventing obesity, diabetes and, in turn, cardiovascular events. According to these data, it is important to consider that most of the beneficial effects of n-3 PUFAs can also be obtained by an equilibrate nutrition program.
authors.affiliation: Department of Clinical and Experimental Medicine, Regional Reference Centre for Coagulation Disorders, "Federico II" University, 80131 Naples, Italy. dario.diminno@hotmail.it
authors.forename: Matteo Nicola Dario
authors.initials: MN
authors.lastname: Di Minno
authors.forename: Anna
authors.initials: A
authors.lastname: Russolillo
authors.forename: Roberta
authors.initials: R
authors.lastname: Lupoli
authors.forename: Pasquale
authors.initials: P
authors.lastname: Ambrosino
authors.forename: Alessandro
authors.initials: A
authors.lastname: Di Minno
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tarantino
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005234:Fatty Liver / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D008099:Liver / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D065626:Non-alcoholic Fatty Liver Disease; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D015525:Fatty Acids, Omega-3
keywords: Animal models; Hepatic steatosis; Non-alcoholic fatty liver disease; Omega-3 polyunsaturated fatty acids