Published online Jun 14, 2015. doi: 10.3748/wjg.v21.i22.7008
Peer-review started: December 29, 2014
First decision: January 22, 2015
Revised: February 20, 2015
Accepted: April 9, 2015
Article in press: April 9, 2015
Published online: June 14, 2015
Processing time: 172 Days and 1.4 Hours
AIM: To examine whether poly-unsaturated fatty acid (PUFA) therapy is beneficial for improving nonalcoholic steatohepatitis (NASH).
METHODS: In total, 78 patients pathologically diagnosed with NASH were enrolled and were randomly assigned into the control group and the PUFA therapy group (added 50 mL PUFA with 1:1 ratio of EHA and DHA into daily diet). At the initial analysis and after 6 mo of PUFA therapy, parameters of interest including liver enzymes, lipid profiles, markers of inflammation and oxidation, and histological changes were evaluated and compared between these two groups.
RESULTS: At the initial analysis, in patients with NASH, serum levels of alanine aminotransferase (ALT) and aspartase aminotransferase (AST) were slightly elevated. Triglyceride (TG), total cholesterol (TC) and low-density lipoprotein cholesterol levels, markers of systemic inflammation [C-reactive protein (CRP)] and oxidation [malondialdehyde (MDA)], as well as fibrosis parameters of type IV collagen and pro-collagen type III pro-peptide were also increased beyond the normal range. Six months later, ALT and AST levels were significantly reduced in the PUFA group compared with the control group. In addition, serum levels of TG and TC, CRP and MDA, and type IV collagen and pro-collagen type III pro-peptide were also simultaneously and significantly reduced. Of note, histological evaluation showed that steatosis grade, necro-inflammatory grade, fibrosis stage, and ballooning score were all profoundly improved in comparison to the control group, strongly suggesting that increased PUFA consumption was a potential way to offset NASH progression.
CONCLUSION: Increased PUFA consumption is a potential promising approach for NASH prevention and reversal.
Core tip: Epidemiologically, it has been reported that the prevalence of non-alcoholic fatty liver disease is increasing significantly and its associated morbidities, including non-alcoholic steatohepatitis (NASH) and hepatic failure, also impose great health and economic burdens on individuals and the whole of society. Preliminary data from our study showed that 6 mo poly-unsaturated fatty acid (PUFA) therapy improved NASH, as reflected by laboratory examination and histological evaluation. Future study is warranted to investigate whether long-term consumption of PUFA could completely reverse NASH and reduce the incidence of hepatic failure.