Supplementary table 1. Published data on the use of n 3 polyunsaturated fatty acids in NAFLD.
Author
year
Nobili 2012
Study population
Children with
NAFLD
Nobili 2011
Children with
NAFLD
Sofi
2010
Patients with
NAFLD on
ultrasound
Type of
study
Randomized
controlled
Doubleblind
randomized
controlled
Dose and
product
DHA 250mg/d,
DHA 500mg/d,
Placebo
24 months of
treatment
3 groups DHA
250mg/d,
DHA 500mg/d,
Placebo
6 months of
treatment
(20 children
per group)
Outcome
measures
Ultrasound,
Triglycerides,
ALT, BMI,
HOMA
Liver biopsy,
Ultrasound,
(20 children Insulin
per group)
sensitivity
index, ALT,
triglycerides,
BMI
Randomized Dietary
11
DPI, Liver
controlled
recommendation
enzymes,
+6.5ml/d of
(intervention triglycerides,
olive oil
group – 6,
adiponectin
enriched with n- control
3 PUFA,
group – 5)
Dietary
recommendation
alone
60
12 months of
treatment
Cussons
2009
Women with
NAFLD and PCOS
Chen 2008
Elevated
Randomized 5 g omega-3
transaminases and
placebo
fatty acids/d. or
hypertriglyceridemia controlled
placebo for
24 weeks
Patients with
Randomized Group DP:
NAFLD
into 2
AHA
groups
recommended
diet and
polyunsaturated
fatty acid 2g/d
Group D: AHA
regular diet
6 months of
treatment
Spadaro
2008
Number of
subjects
60
Randomized Omega-3 fatty
controlled – acids 4g/d,
crossover
Placebo
study
8 weeks of
treatment
Conclusion
DHA
supplementation
improves liver
steatosis in children
with NAFLD
DHA
supplementation
improves liver
steatosis and insulin
sensitivity in
children with
NAFLD
Preliminary study
showed that longterm consumption of
olive oil enriched
with n-3 PUFA in
NAFLD decreased
circulating liver
enzymes
and triglycerides,
with significant
improvement of
adiponectin levels.
25
Proton
magnetic
resonance
spectroscopy,
blood
pressure,
Fasting lipids
Omega-3 fatty acid
supplementation has
a beneficial effect on
liver fat content and
other cardiovascular
risk factors in
women with PCOS,
including those with
NAFLD.
24
LFT,
triglycerides
40
Ultrasound,
ALT,
HOMA,
Tumor
necrosis
factor-alpha
serum levels,
Triglycerides
Supplementation
improved
triglycerides and
transaminases.
ALT, triglycerides,
serum tumor necrosis
factor-alpha levels,
and fatty liver
improved after
polyunsaturated fatty
acid administration
(20 per
group)
Zhu 2008
Capanni
2009
Tanaka
2008
Vega
2008
Patients with
NAFLD and hyper
lipidemia
Patients with
NAFLD
Randomized Group A:
controlled
recommended
diet and 2g n-3
PUFA from seal
oils 3x/d
Group B:
recommended
diet and 2g
placebo 3x/d
Open label
134
n-3 PUFA from seal
oils is beneficial for
patients with
NAFLD associated
with hyperlipidemia
and can improve
symptoms scores,
ALT, serum lipid
levels, and normalize
US evidence.
24 weeks of
treatment
Symptom
scores, ALT,
(66 in Group AST, GGT,
A, 68 in
Serum lipid
Group B)
levels,
Ultrasound,
Weight,
Fasting blood
glucose,
Renal
function,
CBC
n-3 PUFA 1g/d
56
Supplementation
with n-3 PUFA
improves
biochemical,
sonographic and
haemodynamic
abnormalities in liver
steatosis
12 months of
treatment
Patients with biopsy
proven NASH
Open label
EPA 2700mg/d
23
12 months of
treatment
Patients with
elevated liver fat on
MRI
Open label
9g/d of fish oil
8 weeks of
treatment
22
AST, ALT,
GGT,
Triglycerides,
FG, n-6/n-3,
Ultrasound,
Liver
perfusion by
DPI, Food
questionnaire,
BMI
Liver biopsy,
ALT, FFA,
TNF receptor
1 & 2,
ferritin,
thioredoxin,
HOMA,
plasma
glucose,
insulin,
adiponectin,
Weight
MRI,
Lipoproteins,
Adiponectin,
Triglycerides
Beneficial for
patients with NASH
due to antiinflammatory and
antioxidant
properties
N-3 fatty acids at
high doses lower
plasma triglyceride
levels, but there are
no significant
decreases in hepatic
triglyceride content
for the group as a
whole. Plasma
triglyceride lowering
is uniform but liver
response is more
variable.
DHA docosahexaenoic acid; NAFLD non alcoholic fatty liver disease; ALT alanine amino transferase; BMI
body mass index; HOMA homeostatic model of assessment; PUFA polyunsaturated fatty acids; BP blood
pressure; PCOS poly cystic ovary syndrome; LFT liver function tests; DP diet and PUFA; AHA American heart
association; AST aspartate amino transferase; GGT gamma glutamyl transpeptidase; FFA free fatty acids; TNF
tumor necrosis factor α; NASH non alcoholic steatohepatitis; MRI magnetic resonance imaging; DPI Doppler
perfusion index.