title: n-3 polyunsaturated fatty acid supplementation reduces insulin resistance in hepatitis C virus infected patients: a randomised controlled trial.
abstract: BACKGROUND
  Insulin resistance promotes liver disease progression and may be associated with a lower response rate in treated hepatitis C virus (HCV) infected patients. n-3 polyunsaturated fatty acid (PUFA) supplementation may reduce insulin resistance. The present study aimed to evaluate the effect of n-3 PUFA supplementation on insulin resistance in these patients.
  
  
  METHODS
  In a randomised, double-blind clinical trial, 154 patients were screened. After applying inclusion criteria, 52 patients [homeostasis model assessment index of insulin resistance (HOMA-IR ≥2.5)] were randomly divided into two groups: n-3 PUFA (n = 25/6000 mg day(-1) of fish oil) or control (n = 27/6000 mg day(-1) of soybean oil). Both groups were supplemented for 12 weeks and underwent monthly nutritional consultation. Biochemical tests were performed at baseline and after intervention. Statistical analysis was performed using the Wilcoxon Mann-Whitney test for comparisons and the Wilcoxon test for paired data. Statistical package r, version 3.02 (The R Project for Statistical Computing) was used and P < 0.05 (two-tailed) was considered statistically significant.
  
  
  RESULTS
  Comparisons between groups showed that n-3 PUFA supplementation was more effective than the control for reducing HOMA-IR (P = 0.015) and serum insulin (P = 0.016). The n-3 PUFA group not only showed a significant reduction in HOMA-IR 3.8 (3.2-5.0) versus 2.4 (1.8-3.3) (P = 0.002); serum insulin 17.1 (13.8-20.6) μIU mL(-1) versus 10.9 (8.6-14.6) μIU mL(-1) (P = 0.001); and glycated haemoglobin 5.4% (5.0-5.7%) versus 5.1% (4.8-5.6%) (P = 0.011), but also presented an increase in interleukin-1 97.5 (0.0-199.8) pg mL(-1) versus 192.4 (102.2-266.8) pg mL(-1) (P = 0.003) and tumour necrosis factor 121.2 (0.0-171.3) pg mL(-1) versus 185.7 (98.0-246.9) pg mL(-1) (P = 0.003).
  
  
  CONCLUSIONS
  n-3 PUFA supplementation reduces insulin resistance in genotype 1 HCV infected patients.
authors.affiliation: Postgraduate Course in Medicine and Health, Federal University of Bahia, Bahia, Brazil.|Nutrition Science Department, Federal University of Bahia, Bahia, Brazil.
authors.forename: T O
authors.initials: TO
authors.lastname: Freire
authors.affiliation: Nutrition Science Department, Federal University of Bahia, Bahia, Brazil.
authors.forename: R S S B
authors.initials: RS
authors.lastname: Boulhosa
authors.affiliation: Nutrition Science Department, Federal University of Bahia, Bahia, Brazil.
authors.forename: L P M
authors.initials: LP
authors.lastname: Oliveira
authors.affiliation: Nutrition Science Department, Federal University of Bahia, Bahia, Brazil.
authors.forename: R P
authors.initials: RP
authors.lastname: de Jesus
authors.affiliation: Department of Medicine, Division of Gastroenterology and Hepatology, Federal University of Bahia, Bahia, Brazil.
authors.forename: L N
authors.initials: LN
authors.lastname: Cavalcante
authors.affiliation: Laboratory of Immunology, Health Science Institute, Federal University of Bahia, Bahia, Brazil.
authors.forename: D C
authors.initials: DC
authors.lastname: Lemaire
authors.affiliation: Pediatric Department, Federal University of Bahia, Bahia, Brazil.
authors.forename: M B P
authors.initials: MB
authors.lastname: Toralles
authors.affiliation: Postgraduate Course in Medicine and Health, Federal University of Bahia, Bahia, Brazil.|Gastro-Hepatology Unit, Hospital São Rafael of Bahia, Bahia, Brazil.
authors.forename: L G C
authors.initials: LG
authors.lastname: Lyra
authors.affiliation: Postgraduate Course in Medicine and Health, Federal University of Bahia, Bahia, Brazil.|Department of Medicine, Division of Gastroenterology and Hepatology, Federal University of Bahia, Bahia, Brazil.|Gastro-Hepatology Unit, Hospital São Rafael of Bahia, Bahia, Brazil.
authors.forename: A C
authors.initials: AC
authors.lastname: Lyra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D019587:Dietary Supplements; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005234:Fatty Liver / Q000150:complications; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage; D005838:Genotype; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged
chemical_list: D015525:Fatty Acids, Omega-3; D005395:Fish Oils; D007328:Insulin
keywords: chronic hepatitis C; inflammation; insulin resistance; n-3 PUFA supplementation; nutrition