title: A double-blind, placebo-controlled randomized trial to evaluate the efficacy of docosahexaenoic acid supplementation on hepatic fat and associated cardiovascular risk factors in overweight children with nonalcoholic fatty liver disease.
abstract: OBJECTIVE
  Very little information is available on whether docosahexaenoic acid (DHA) supplementation has a beneficial effect on liver fat and cardiovascular disease (CVD) risk factors in children with nonalcoholic fatty liver disease (NAFLD). In a double-blind, placebo-controlled randomized trial we investigated whether 6-month treatment with DHA improves hepatic fat and other fat depots, and their associated CVD risk factors in children with biopsy-proven NAFLD.
  
  
  RESULTS
  Of 58 randomized children, 51 (25 DHA, 26 placebo) completed the study. The main outcome was the change in hepatic fat fraction as estimated by magnetic resonance imaging. Secondary outcomes were changes in visceral adipose tissue (VAT), epicardial adipose tissue (EAT), and left ventricular (LV) function, as well as alanine aminotransferase (ALT), triglycerides, body mass index-standard deviation score (BMI-SDS), and insulin sensitivity. At 6 months, the liver fat was reduced by 53.4% (95% CI, 33.4-73.4) in the DHA group, as compared with 22.6% (6.2-39.0) in the placebo group (P = 0.040 for the comparison between the two groups). Likewise, in the DHA group VAT and EAT were reduced by 7.8% (0-18.3) and 14.2% (0-28.2%), as compared with 2.2% (0-8.1) and 1.7% (0-6.8%) in the placebo group, respectively (P = 0.01 for both comparisons). There were no significant between-group changes for LV function as well as BMI-SDS and ALT, while fasting insulin and triglycerides significantly decreased in the DHA-treated children (P = 0.028 and P = 0.041, respectively).
  
  
  CONCLUSIONS
  DHA supplementation decreases liver and visceral fat, and ameliorates metabolic abnormalities in children with NAFLD.
authors.affiliation: Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, 00161 Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Pacifico
authors.affiliation: Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Bonci
authors.affiliation: Department of Radiological Sciences, Sapienza University of Rome, 00161 Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Di Martino
authors.affiliation: Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, 00161 Rome, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Versacci
authors.affiliation: Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, 00161 Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Andreoli
authors.affiliation: Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, 00161 Rome, Italy.
authors.forename: L M
authors.initials: LM
authors.lastname: Silvestri
authors.affiliation: Institute of Translational Pharmacology, National Research Council, Via del Fosso del Cavaliere, 100, 00133 Rome, Italy. Electronic address: claudio.chiesa@ift.cnr.it.
authors.forename: C
authors.initials: C
authors.lastname: Chiesa
mesh_terms: D000273:Adipose Tissue / Q000187:drug effects*; D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D001706:Biopsy; D015992:Body Mass Index; D002648:Child; D004281:Docosahexaenoic Acids / Q000008:administration & dosage / Q000494:pharmacology*; D004311:Double-Blind Method; D005215:Fasting / Q000097:blood; D005231:Fatty Acids, Unsaturated / Q000494:pharmacology; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D050152:Intra-Abdominal Fat / Q000187:drug effects / Q000473:pathology; D008099:Liver / Q000187:drug effects* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000178:diet therapy* / Q000473:pathology; D050177:Overweight / Q000097:blood / Q000178:diet therapy* / Q000473:pathology; D010496:Pericardium / Q000187:drug effects / Q000473:pathology; D012307:Risk Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D005231:Fatty Acids, Unsaturated; D007328:Insulin; D014280:Triglycerides; D004281:Docosahexaenoic Acids; D000410:Alanine Transaminase
keywords: Cardiac function; Children; Docosahexaenoic acid; Epicardial adipose tissue; Liver fat; NAFLD; Visceral adipose tissue