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World J Gastroenterol. Nov 7, 2008; 14(41): 6395-6400
Published online Nov 7, 2008. doi: 10.3748/wjg.14.6395
Effects of n-3 polyunsaturated fatty acids from seal oils on nonalcoholic fatty liver disease associated with hyperlipidemia
Feng-Shang Zhu, Su Liu, Xi-Mei Chen, Zhi-Gang Huang, Dong-Wei Zhang
Feng-Shang Zhu, Xi-Mei Chen, Zhi-Gang Huang, Dong-Wei Zhang, Department of Gastroenterology, Tongji Hospital, Digestive Disease Institute of Tongji University, Shanghai 200065, China
Su Liu, Department of Gastroenterology, Center Hospital of Shanghai Zhabei District, Shanghai 200072, China
Author contributions: Zhu FS , Liu S and Chen XM designed the research; Zhu FS, Chen XM and Zhang DW performed the research; Huang ZG and Zhang DW advised on the research design; Chen XM originated the research topic and supervised the project; Zhu FS, Liu S, Huang ZG and Zhang DW analyzed the results and wrote the paper.
Supported by Shanghai Natural Science Fund of China, 05ZR14156
Correspondence to: Feng-Shang Zhu, MD, Department of Gastroenterology, Tongji Hospital, Digestive Disease Institute of Tongji University, Shanghai 200065, China. zhufengshang@126.com
Telephone: +86-21-66111075 Fax: +86-21-66111149
Received: August 19, 2008
Revised: October 9, 2008
Accepted: October 16, 2008
Published online: November 7, 2008
Abstract

AIM: To investigate the efficacy and safety of n-3 polyunsaturated fatty acids (PUFA) from seal oils for patients with nonalcoholic fatty liver disease (NAFLD) associated with hyperlipidemia.

METHODS: One hundred and forty-four patients with NAFLD associated with hyperlipidemia were included in the 24-wk, randomized, controlled trial. The patients were randomized into two groups. Group A (n = 72) received recommended diet and 2 g n-3 PUFA from seal oils, three times a day. Group B (n = 72) received recommended diet and 2 g placebo, three times a day. Primary endpoints were fatty liver assessed by symptom scores, liver alanine aminotransferase (ALT) and serum lipid levels after 8, 12, 16, and 24 wk. Hepatic fat infiltration was detected by ultrasonography at weeks 12 and 24 after treatment.

RESULTS: A total of 134 patients (66 in group A, 68 in group B) were included in the study except for 10 patients who were excluded from the study. After 24 wk of treatment, no change was observed in body weight, fasting blood glucose (FBG), renal function and blood cells of these patients. Total symptom scores, ALT and triglyceride (TG) levels decreased more significantly in group A than in group B (P < 0.05). As expected, there was a tendency toward improvement in aspartate aminotransferase (AST), γ-glutamyltranspeptidase (GGT), and total cholesterol (TCHO) and high-density lipoprotein (HDL) cholesterol levels (P < 0.05) after administration in the two groups. However, no significant differences were found between the two groups. The values of low-density lipoprotein (LDL) were significantly improved in group A (P < 0.05), but no significant change was found in group B at different time points and after a 24-wk treatment. After treatment, complete fatty liver regression was observed in 19.70% (13/66) of the patients, and an overall reduction was found in 53.03% (35/66) of the patients in group A. In contrast, in group B, only five patients (7.35%, 5/68) achieved complete fatty liver regression (P = 0.04), whereas 24 patients (35.29%, 24/68) had a certain improvement in fatty liver (P = 0.04). No serious adverse events occurred in all the patients who completed the treatment.

CONCLUSION: Our results indicate that n-3 PUFA from seal oils is safe and efficacious for patients with NAFLD associated with hyperlipidemia and can improve their total symptom scores, ALT, serum lipid levels and normalization of ultrasonographic evidence. Further study is needed to confirm these results.

Keywords: Nonalcoholic fatty liver disease; Polyunsaturated fatty acids; Seal oil; Hyperlipidemia; Therapy