Research advances in omega-3 polyunsaturated fatty acids in treatment of nonalcoholic fatty liver disease
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摘要: 随着人们生活方式和饮食结构的改变,非酒精性脂肪性肝病(NAFLD)发病率逐年上升,严重威胁人类健康。NAFLD疗法一直是基础和临床肝病研究的热门领域。近年来,诸多研究揭示omega-3多不饱和脂肪酸(ω3-PUFA)可促进脂肪酸氧化并改善肠道稳态,从而改善脂代谢和肝脏炎症,因而越来越多的临床研究开始将ω3-PUFA运用于NAFLD的治疗中。然而,ω3-PUFA治疗NAFLD的机制尚不明确,相关临床研究也存在一定局限性。主要介绍了ω3-PUFA在NAFLD中发挥的作用以及相关的临床研究结果,并进一步讨论ω3-PUFA治疗NAFLD尚需解决的问题。Abstract: With the changes in people's lifestyle and dietary structure,the incidence rate of nonalcoholic fatty liver disease(NAFLD) has been increasing year by year,and NAFLD has become a serious threat to human health. The treatment of NAFLD has always been a hot topic of basic and clinical research on liver diseases. In recent years,many studies have revealed that omega-3 polyunsaturated fatty acids(ω3-PUFA) can promote fatty acid oxidation,improve intestinal homeostasis,and thus improve lipid metabolism and liver inflammation,and therefore,more and more clinical studies have applied ω3-PUFA in the treatment of NAFLD. However,the mechanism of ω3-PUFA in the treatment of NAFLD is still unclear,and there are certain limitations in related clinical studies. This article mainly introduces the role of ω3-PUFA in NAFLD and the results of related clinical studies and further discusses the problems that need to be solved in ω3-PUFA for the treatment of NAFLD.
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Key words:
- non-alcoholic fatty liver disease /
- fatty acids,omega-3 /
- therapeutics
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[1] JUMP DB,DEPNER CM,SASMITA T,et al. Potential for dietaryω-3 fatty acids to prevent nonalcoholic fatty liver disease and reduce the risk of primary liver cancer[J]. Adv Nutr,2015,6(6):694-702. [2] NOBILI V,ALISI A,MUSSO G,et al. Omega-3 fatty acids:Mechanisms of benefit and therapeutic effects in pediatric and adult NAFLD[J]. Clin Lab Sci,2016,53(2):106-120. [3] PAWAR A,JUMP DB. Unsaturated fatty acid regulation of peroxisome proliferator-activated receptorαactivity in rat primary hepatoctes[J]. J Biol Chem,2003,278(38):35931-35939. [4] JUMP DB,TRIPATHY S,DEPNER CM. Fatty acid-regulated transcription factors in the liver[J]. Annu Rev Nutr,2013,33:249-269. [5] LAMBERT JE,RAMOS-ROMAN MA,BROWNING JD,et al.Increased de novo lipogenesis is a distinct characteristic of individuals with nonalcoholic fatty liver disease[J]. Gastroenterology,2014,146(3):726-735. [6] PAGLIALUNGA S,DEHN CA. Clinical assessment of hepatic de novo lipogenesis in non-alcoholic fatty liver disease[J].Lipids Health Dis,2016,15(1):159. [7] GNONI A,GIUDETTI AM. Dietary long-chain unsaturated fatty acids acutely and differently reduce the activities of lipogenic enzymes and of citrate carrier in rat liver[J]. J Physiol Biochem,2016,72(3):485-494. [8] SCORLETTI E,BYRNE CD. Omega-3 fatty acids and nonalcoholic fatty liver disease:Evidence of efficacy and mechanism of action[J]. Mol Aspects Med,2018,64:135-146. [9] LYTLE KA,WONG CP,JUMP DB. Docosahexaenoic acid blocks progression of western diet-induced nonalcoholic steatohepatitis in obese Ldlr-/-mice[J]. PLo S One,2017,12(4):e0173376-e0173376. [10] DEPNER CM,TRABER MG,BOBE G,et al. A metabolomic analysis of omega-3 fatty acid-mediated attenuation of western diet-induced nonalcoholic steatohepatitis in LDLR-/-mice[J]. PLo S One,2013,8(12):e83756-e83756. [11] DEPNER CM,PHILBRICK KA,JUMP DB. Docosahexaenoic acid attenuates hepatic inflammation,oxidative stress,and fibrosis without decreasing hepatosteatosis in a Ldlr(-/-)mouse model of western diet-induced nonalcoholic steatohepatitis[J]. J Nutr,2013,143(3):315-323. [12] LYTLE KA,DEPNER CM,WONG CP,et al. Docosahexaenoic acid attenuates Western diet-induced hepatic fibrosis in Ldlr-/-mice by targeting the TGFβ-Smad3 pathway[J]. J Lipid Res,2015,56(10):1936-1946. [13] WATSON H,MITRA S,CRODEN FC,et al. A randomised trial of the effect of omega-3 polyunsaturated fatty acid supplements on the human intestinal microbiota[J]. Gut,2017,67(11):1974-1983. [14] PROVENZANO A,MILANI S,VIZZUTTI F,et al. n-3 polyunsaturated fatty acids worsen inflammation and fibrosis in experimental nonalcoholic steatohepatitis[J]. Liver Int,2014,34(6):918-930. [15] BOYRAZ M,PIRGON,DNDAR B,et al. Long-term treatment with n-3 polyunsaturated fatty acids as a monotherapy in children with nonalcoholic fatty liver disease[J]. J Clin Res Pediatr Endocrinol,2015,7(2):121-127. [16] NOGUEIRA MA,OLIVEIRA CP,FERREIRA ALVES VA,et al.Omega-3 polyunsaturated fatty acids in treating non-alcoholic steatohepatitis:A randomized,double-blind,placebo-controlled trial[J]. Clin Nutr,2016,35(3):578-586. [17] TOBIN D,BREVIK-ANDERSEN M,QIN Y,et al. Evaluation of a high concentrate omega-3 for correcting the omega-3fatty acid nutritional deficiency in non-alcoholic fatty liver disease(CONDIN)[J]. Nutrients,2018,10(8):1126-1126. [18] DASARATHY S,DASARATHY J,KHIYAMI A,et al. Doubleblind randomized placebo-controlled clinical trial of omega 3fatty acids for the treatment of diabetic patients with nonalcoholic steatohepatitis[J]. J Clin Gastroenterol,2015,49(2):137-144. [19] KARLAS T,PETROFF D,SASSO M,et al. Individual patient data meta-analysis of controlled attenuation parameter(CAP)technology for assessing steatosis[J]. J Hepatol,2017,66(5):1022-1030. [20] TUTINO V,de NUNZIO V,CARUSO MG,et al. Aerobic physical activity and a low glycemic diet reduce the aa/epa ratio in red blood cell membranes of patients with NAFLD[J]. Nutrients,2018,10(9). pii:E1299 [21] SOFI F,GIANGRANDI I,CESARI F,et al. Effects of a 1-year dietary intervention with n-3 polyunsaturated fatty acid-enriched olive oil on non-alcoholic fatty liver disease patients:A preliminary study[J]. Int J Food Sci Nutr,2010,61(8):792-802. [22] HE XX,WU XL,CHEN RP,et al. Effectiveness of omega-3polyunsaturated fatty acids in non-alcoholic fatty liver disease:A Meta-analysis of randomized controlled trials[J].PLo S One,2016,11(10):e0162368-e0162368. [23] LU W,LI S,LI J,et al. Effects of omega-3 fatty acid in nonalcoholic fatty liver disease:A Meta-analysis[J]. Gastroenterol Res Pract,2016,2016:1459790-1459790. [24] PARKER HM,JOHNSON NA,BURDON CA,et al. Omega-3supplementation and non-alcoholic fatty liver disease:A systematic review and meta-analysis[J]. J Hepatol,2012,56(4):944-951. [25] KLEINER DE,BEDOSSA P. Liver histology and clinical trials for nonalcoholic steatohepatitis-perspectives from 2 pathologists[J]. Gastroenterology,2015,149(6):1305-1308. [26] NOBILI V,BEDOGNI G,ALISI A,et al. Docosahexaenoic acid supplementation decreases liver fat content in children with nonalcoholic fatty liver disease:Double-blind randomised controlled clinical trial[J]. Arch Dis Child,2011,96(4):350-353. [27] PACIFICO L,BONCI E,di MARTINO M,et al. A doubleblind,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[J]. Nutr Metab Cardiovasc Dis,2015,25(8):734-741. [28] MACHANN J,THAMER C,SCHNOEDT B,et al. Hepatic lipid accumulation in healthy subjects:A comparative study using spectral fat-selective MRI and volume-localized1H-MR spectroscopy[J]. Magn Reson Med,2006,55(4):913-917. [29] SCORLETTI E,WEST A L,BHATIA L,et al. Treating liver fat and serum triglyceride levels in NAFLD,effects of PNPLA3 and TM6SF2 genotypes:Results from the WELCOME trial[J]. J Hepatol,2015,63(6):1476-1483. [30] ALLAIRE J,COUTURE P,LECLERC M,et al. A randomized,crossover,head-to-head comparison of eicosapentaenoic acid and docosahexaenoic acid supplementation to reduce inflammation markers in men and women:The Comparing EPA to DHA(ComparED)Study[J]. Am J Clin Nutr,2016,104(2):280-287. [31] PARK HG,LAWRENCE P,ENGEL MG,et al. Metabolic fate of docosahexaenoic acid(DHA; 22:6n-3)in human cells:Direct retroconversion of DHA to eicosapentaenoic acid(20:5n-3)dominates over elongation to tetracosahexaenoic acid(24:6n-3)[J]. FEBS Lett,2016,590(18):3188-3194. [32] SANYAL AJ,ABDELMALEK MF,SUZUKI A,et al. No significant effects of ethyl-eicosapentanoic acid on histologic features of nonalcoholic steatohepatitis in a phase 2 tria L[J].Gastroenterology,2014,147(2):377-384.
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