Effect of omega-3 supplementation on fatty liver and visceral adiposity indices in diabetic patients with non-alcoholic fatty liver disease: A randomized controlled trial

The effect of dietary approaches to stop hypertension (DASH) diet on fatty liver and cardiovascular risk factors in subjects with metabolic syndrome: a randomized controlled trial

BACKGROUND

Metabolic syndrome (MetS) as a multifactorial disorder is associated with non-communicable diseases. The dietary approaches to stop hypertension (DASH) diet is a healthy dietary pattern. We investigated the effect of the DASH diet on fatty liver and cardiovascular risk factors in subjects with MetS.

METHODS

60 Subjects with MetS were assigned into the intervention group (DASH diet) or the control group (a healthy diet). Fatty liver index (FLI), hepatic steatosis index (HSI), waist circumference (WC), weight, body mass index (BMI), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c) were evaluated at the beginning and after intervention. Equations of fatty liver indices such as FLI and HSI are based on liver enzymes, anthropometric variables, sex and having diabetes.

RESULTS

30 subjects in the intervention group and 29 subjects in the control group completed the study. We found a significant reduction in the intervention group compared to the control group in FLI (-13.06 ± 10.03 vs. -2.90 ± 6.82;P < 0.001), HSI (-2.72 ± 2.59 vs. -0.81 ± 3.80;P = 0.02), WC (-6.02 ± 4.24 vs. -2.24 ± 4.28;P = 0.001), weight (-3.39 ± 2.53 vs. -1.51 ± 2.72;P = 0.008), BMI (-1.25 ± 0.93 vs. -0.56 ± 1.01;P = 0.008), DBP (-5.16 ± 3.92 vs. -1.50 ± 7.04;P = 0.01), SBP (-6.97 ± 8.21 vs. -1.36 ± 6.83;P = 0.006), TG (-18.50 ± 14.32 vs. 0.60 ± 23.81;P < 0.001), TC (-16.10 ± 17.94 vs. -5.07 ± 23.62;P = 0.04) and LDL-c (-13.50 ± 9.58 vs. -4.90 ± 18.28;P = 0.02). These results remained significant after adjusting for confounding factors, except for TC (P = 0.25).

CONCLUSIONS

The DASH diet was more effective than the control diet in managing fatty liver and cardiovascular risk factors.

TRIAL REGISTRATION

The trial was registered on 21 October 2022 at Iranian Registry of Clinical Trials (IRCT20180201038585N12, URL: https://irct.behdasht.gov.ir/trial/66161 ).

Investigating the correlation between polyunsaturated fatty acids intake and non-invasive biomarkers of liver fibrosis

BACKGROUND

Polyunsaturated fatty acids (PUFAs) have potentially beneficial effects on the liver tissue. Noninvasive biomarkers, including imaging techniques and blood-based biomarkers, are important tools for assessing liver fibrosis. This study aims to investigate the relationship between dietary intake of PUFAs and noninvasive biomarkers for liver fibrosis in the general population.

METHODS

The National Health and Nutrition Examination Survey 2017-2018 (NHANES 2017-2018) datasets were used. Fibrosis-4 index (FIB-4), FIB-8, and Fatty Liver Index (FLI) were calculated for each subject. The fibrosis groups were compared based on their intake of PUFA. The correlation between each score and PUFA intake was calculated. Correlation analysis was performed.

RESULTS

A total of 5087 subjects (50.36% female) with a mean age of 49.37 ± 12.14 were evaluated. The mean of median liver stiffness measurement (LSM) was 5.92 ± 5.20 kPa (kPa). The mean PUFA intake was reported as 20.2 ± 13.9 gm. Fibrosis (F) grouping revealed that 190 subjects had F3, and 154 F4. HDL had a significant correlation with Docosapentaenoic acid (DPA) intake (r = -0.038, p = 0.007). Moreover, AST and ALT had a significant correlation with Docosahexaenoic acid (DHA) intake (r = 0.033 and 0.059, p = 0.019 and < 0.001, respectively). FIB-4 and FIB-8 had no correlation with PUFA intake. FLI had a significant correlation with DPA acid (r = 0.062, p < 0.001).

CONCLUSION

A significant correlation between FLI, and PUFA intake suggests that increasing PUFA consumption could have a positive impact on liver health.

Optimized strategy among diet, exercise, and pharmacological interventions for nonalcoholic fatty liver disease: A network meta-analysis of randomized controlled trials

BACKGROUND

Emerging treatment methods, including exercise, diet, and drugs, for nonalcoholic fatty liver disease have been proposed. However, the differences in their efficacy have not been determined. We aimed to compare the effects of these treatments excluding surgery via a systematic review and network meta-analysis of randomized controlled trials.

DATA SOURCE

The data sources included PubMed, Embase, Web of Science and Cochrane up to February 1st, 2023. The endpoints consisted of body mass index (BMI), serum markers of metabolism and liver injury markers, liver fat content, and stiffness.

RESULTS

A total of 174 studies with 10,183 patients were included in this meta-analysis. In terms of improving BMI, Pan-agonist of peroxisome proliferator-activated receptors (PPAR) is the best treatment with the highest SUCRA (surface under the cumulative ranking) of 84.8% (mean = -3.40, 95% CI -5.55, -1.24) by the comparative effectiveness ranking. GLP-1 (glucagon-like peptide-1) has the best effect in improving the liver fat content based on the MRI-PDFF, steatosis score (SUCRA 99.7%, mean = -2.19, 95% CI -2.90, -1.48) and ballooning score (SUCRA 61.2%, mean = -0.82, 95% CI -4.46, 2.83).

CONCLUSIONS

Pan-agonist of PPAR was the most efficacious regimen in lowering BMIs, whereas GLP-1R agonists achieved the highest efficacy of steatosis improvement in this network meta-analysis.

The effects of weight loss interventions on children and adolescents with non-alcoholic fatty liver disease: A systematic review and meta-analysis

Background

Overall, there is conflicting evidence regarding the beneficial effects of optimal lifestyle modification, particularly weight loss interventions, with nonalcoholic fatty liver disease (non-alcoholic fatty liver disease (NAFLD)). Therefore, this study investigated the effects of weight loss interventions on laboratory and clinical parameters in children and adolescents with NAFLD.

Methods

Original databases (PubMed/MEDLINE, Web of Science, SCOPUS, and Embase) were searched using standard keywords to identify all controlled trials investigating the effects of weight loss interventions among NAFLD children and adolescents. Pooled weighted mean difference and 95% confidence intervals were achieved by random-effects model analysis.

Results

Eighteen eligible clinical trials were included in this systematic review and meta-analysis. The pooled findings showed that especially more intense weight loss interventions significantly reduced the glucose (p = 0.007), insulin (p = 0.002), homeostatic model assessment-insulin resistance (HOMA-IR) (p = 0.003), weight (p = 0.025), body mass index (BMI) (p = 0.003), BMI z-score (p < 0.001), waist circumference (WC) (p = 0.013), triglyceride (TG) (p = 0.001), and aspartate transaminase (AST) (p = 0.027). However, no significant changes were found in total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), alanine transaminase (ALT), and hepatic steatosis grades (all p > 0.05) following weight loss interventions.

Conclusions

Weight loss interventions had significant effects on NAFLD-related parameters including glucose, insulin, HOMA-IR, weight, BMI, BMI z-score, WC, TG, and AST.

Effects of omega-3 supplementation on anxiety-like behaviors and neuroinflammation in Wistar rats following cafeteria diet-induced obesity

ABSTRACTObjetives: Omega-3 (n3) fatty acids have been studied as an option to alleviate the harmful effects of obesity. However, its role in obesity-related behavioral changes is still controversial. This study aimed to evaluate the effects of n3 on behavior and neuroinflammation in obese animals. Methods: Male Wistar rats were divided into four groups: control diet (CT), CT+n3, cafeteria diet (CAF), and CAF+n3. Diet was administered for 13 weeks, and n3 was supplemented during the last 5 weeks. Metabolic and biochemical parameters were evaluated, as well as anxiety-like behaviors. Immunoblots were conducted in the animals' cerebral cortex and hippocampus to assess changes in neuroinflammatory markers.Results: CAF-fed animals showed higher weight gain, visceral adiposity, fasting glucose, total cholesterol, triglycerides, and insulin levels, and n3 improved the lipid profile and restored insulin sensitivity. CAF-fed rats showed anxiety-like behaviors in the open field and light-dark box tasks but not in the contextual aversive conditioning. Omega-3 did not exert any effect on these behaviors. Regarding neuroinflammation, diet and supplementation acted in a region-specific manner. In the hippocampus, CAF reduced claudin-5 expression with no effect of n3, indicating a brain-blood barrier disruption following CAF. Furthermore, in the hippocampus, the glial fibrillary acidic protein (GFAP) and toll-like receptor 4 (TLR-4) were reduced in treated obese animals. However, n3 could not reverse the TLR-4 expression increase in the cerebral cortex.Discussion: Although n3 may protect against some neuroinflammatory manifestations in the hippocampus, it does not seem sufficient to reverse the increase in anxiolytic manifestations caused by CAF.

Bioactive signalling lipids as drivers of chronic liver diseases

Lipids are important in multiple cellular functions, with most having structural or energy storage roles. However, a small fraction of lipids exert bioactive roles through binding to G protein-coupled receptors and induce a plethora of processes including cell proliferation, differentiation, growth, migration, apoptosis, senescence and survival. Bioactive signalling lipids are potent modulators of metabolism and energy homeostasis, inflammation, tissue repair and malignant transformation. All these events are involved in the initiation and progression of chronic liver diseases. In this review, we focus specifically on the roles of bioactive lipids derived from phospholipids (lyso-phospholipids) and poly-unsaturated fatty acids (eicosanoids, pro-resolving lipid mediators and endocannabinoids) in prevalent chronic liver diseases (alcohol-associated liver disease, non-alcoholic fatty liver disease, viral hepatitis and hepatocellular carcinoma). We discuss the balance between pathogenic and beneficial bioactive lipids as well as potential therapeutic targets related to the agonism or antagonism of their receptors.

Comparative effectiveness of multiple different treatment regimens for nonalcoholic fatty liver disease with type 2 diabetes mellitus: a systematic review and Bayesian network meta-analysis of randomised controlled trials

BACKGROUND

Nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) are closely related and mutually contribute to the disease's development. There are many treatment options available to patients. We provide a comprehensive overview of the evidence on the treatment effects of several potential interventions for NAFLD with T2DM.

METHODS

This systematic review and network meta-analysis included searches of PubMed, Embase, Cochrane Library, and Web of Science from inception to June 30, 2023, for randomised controlled trials of treatment of NAFLD with T2DM. We performed Bayesian network meta-analyses to summarise effect estimates of comparisons between interventions. We applied the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) frameworks to rate all comparative outcomes' certainty in effect estimates, categorise interventions, and present the findings. This study was registered with PROSPERO, CRD42022342373.

RESULTS

Four thousand three hundred and sixty-nine records were retrieved from the database and other methods, of which 24 records were eligible for studies enrolling 1589 participants. Eight clinical indicators and 14 interventions were finally in focus. Referring to the lower surface under the cumulative ranking curves (SUCRA) and the league matrix table, exenatide and liraglutide, which are also glucagon-like peptide-1 receptor agonists (GLP-1RAs), showed excellent potential to reduce liver fat content, control glycemia, reduce body weight, and improve liver function and insulin resistance. Exenatide was more effective in reducing glycated haemoglobin (HbA1c) (mean difference (MD) 0.32, 95%CI 0.12 to 0.52), lowering BMI (MD 0.81, 95%CI 0.18 to 1.45), and lowering alanine transaminase (ALT) (MD 10.96, 95%CI 5.27 to 16.66) compared to liraglutide. However, this evidence was assessed as low certainty. Omega-3 was the only intervention that did not have a tendency to lower HbA1c, with standard-treatment (STA-TRE) as reference (MD - 0.17, 95%CI - 0.42 to 0.07). Glimepiride is the only intervention that causes an increase in ALT levels, with standard-treatment (STA-TRE) as reference (MD - 11.72, 95%CI - 17.82 to - 5.57). Based on the available evidence, the treatment effects of pioglitazone, dapagliflozin, and liraglutide have a high degree of confidence.

CONCLUSIONS

The high confidence mandates the confident application of these findings as guides for clinical practice. Dapagliflozin and pioglitazone are used for glycaemic control in patients with NAFLD combined with T2DM, and liraglutide is used for weight loss therapy in patients with abdominal obesity. The available evidence does not demonstrate the credibility of the effectiveness of other interventions in reducing liver fat content, visceral fat area, ALT, and insulin resistance. Future studies should focus on the clinical application of GLP-1Ras and the long-term prognosis of patients.

Exploring the Impact of Nutrition on Non-Alcoholic Fatty Liver Disease Management: Unveiling the Roles of Various Foods, Food Components, and Compounds

There is a need to introduce standardized treatment options for non-alcoholic fatty liver disease (NAFLD) due to its global prevalence and the complications of this disease. Many studies have revealed that food-derived substances may be beneficial in dealing with this disease. Therefore, this review aims to evaluate the recently published studies on the food-derived treatment options for NAFLD. A comprehensive search of the PubMed database using keywords such as "NAFLD", "nutrition", "food", "derived", "therapy", and "guidelines" yielded 219 relevant papers for our analysis, published from 2004 to 2023. The results show the significant benefits of food-derived treatment in NAFLD therapy, including improvements in liver histology, hepatic fat amounts, anthropometric measures, lipid profile, and other metabolic measures. The availability of the substances discussed makes them a significant adjuvant in the treatment of this disease. The usefulness of Viusid as additional therapy to diet and physical activity should be emphasized due to improvements in liver histology; however, many other substances lead to a decrease in liver fat amounts including, e.g., berberine or omega-3 fatty acids. In addition, the synbiotic Protexin seems to be useful in terms of NAFLD treatment, especially because it is effective in both obese and lean subjects. Based on the latest research results, we suggest revising the therapeutic recommendations for patients suffering from NAFLD.

The association between dietary diabetic risk reduction score with anthropometric and body composition variables in overweight and obese women: a cross-sectional study

Dietary diabetes risk reduction score (DDRRs) is inversely associated with a lower risk of type 2 diabetes. Given the importance of the association between body fat and insulin resistance and the effect of diet on these parameters, this study aimed to investigate the association between DDRRS and body composition parameters, including the visceral adiposity index (VAI), lipid accumulation product (LAP), and skeletal muscle mass (SMM). This study was conducted on 291 overweight and obese women aged 18-48 years old recruited from 20 Tehran Health Centers in 2018. The anthropometric indices, biochemical parameters, and body composition were measured. A semi-quantitative food frequency questionnaire (FFQ) was used to calculate DDRRs. Linear regression analysis was used to examine the association between DDRRs and body composition indicators. The mean (SD) age of participants was 36.67 (9.10) years. After adjustment for potential confounders, VAI (β = 0.27, 95% CI = - 0.73, 1.27, Ptrend = 0.052), LAP (β = 8.14, 95% CI = - 10.54, 26.82, Ptrend = 0.069), TF (β = - 1.41, 95% CI = 11.45, 17.30, Ptrend = 0.027), trunk fat percent (TF%) (β = - 21.55, 95% CI = - 44.51, 1.61, Ptrend = 0.074), body fat mass (BFM) (β = - 3.26, 95% CI = - 6.08, - 0.44, Ptrend = 0.026), visceral fat area (VFA) (β = - 45.75, 95% CI = - 86.10, - 5.41, Ptrend = 0.026), waist-to-hip ratio (WHtR) (β = - 0.014, 95% CI = - 0.031, 0.004, Ptrend = 0.066), visceral fat level (VFL) (β = - 0.38, 95% CI = - 5.89, 5.12, Ptrend = 0.064), fat mass index (FMI) (β = - 1.15, 95% CI = - 2.28, - 0.02, Ptrend = 0.048) decreased significantly over tertiles of DDRRs, and also there was no significant association between SMM and DDRRs tertiles (β = - 0.57, 95% CI = - 1.69, 0.53, Ptrend = 0.322). The findings of this study demonstrated that participants with higher adherence to the DDRRs had lower VAI (β = 0.78 vs 0.27) and LAP (β = 20.73 vs 8.14). However, there was no significant association between DDRRs and VAI, LAP and SMM, which are mentioned as the primary outcomes. Future studies with larger sample of both genders are needed to investigate our findings.

What's New in the Treatment of Non-Alcoholic Fatty Liver Disease (NAFLD)

Non-alcoholic fatty liver disease (NAFLD) is a serious health problem due to its high incidence and consequences. In view of the existing controversies, new therapeutic options for NAFLD are still being sought. Therefore, the aim of our review was to evaluate the recently published studies on the treatment of NAFLD patients. We searched for articles in the PubMed database using appropriate terms, including "non-alcoholic fatty liver disease", "nonalcoholic fatty liver disease", "NAFLD", "diet", "treatment", "physical activity", "supplementation", "surgery", "overture" and "guidelines". One hundred forty-eight randomized clinical trials published from January 2020 to November 2022 were used for the final analysis. The results show significant benefits of NAFLD therapy associated with the use of not only the Mediterranean but also other types of diet (including low-calorie ketogenic, high-protein, anti-inflammatory and whole-grain diets), as well as enrichment with selected food products or supplements. Significant benefits in this group of patients are also associated with moderate aerobic physical training. The available therapeutic options indicate, above all, the usefulness of drugs related to weight reduction, as well as the reduction in insulin resistance or lipids level and drugs with anti-inflammatory or antioxidant properties. The usefulness of therapy with dulaglutide and the combination of tofogliflozin with pioglitazone should be emphasized. Based on the results of the latest research, the authors of this article suggest a revision of the therapeutic recommendations for NAFLD patients.

Increased Expression of Hepatic Stearoyl-CoA Desaturase (SCD)-1 and Depletion of Eicosapentaenoic Acid (EPA) Content following Cytotoxic Cancer Therapy Are Reversed by Dietary Fish Oil

Cancer treatment evokes impediments to liver metabolism that culminate in fatty liver. This study determined hepatic fatty acid composition and expression of genes and mediators involved in lipid metabolism following chemotherapy treatment. Female rats bearing the Ward colon tumor were administered Irinotecan (CPT-11) +5-fluorouracil (5-FU) and maintained on a control diet or a diet containing eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA) (2.3 g/100 g fish oil). Healthy animals provided with a control diet served as a reference group. Livers were collected one week after chemotherapy. Triacylglycerol (TG), phospholipid (PL), ten lipid metabolism genes, leptin, and IL-4 were measured. Chemotherapy increased TG content and reduced EPA content in the liver. Expression of SCD1 was upregulated by chemotherapy, while dietary fish oil downregulated its expression. Dietary fish oil down-regulated expression of the fatty acid synthesis gene FASN, while restoring the long chain fatty acid converting genes FADS2 and ELOVL2, and genes involved in mitochondrial β-oxidation (CPT1α) and lipid transport (MTTP1), to values similar to reference animals. Neither leptin nor IL-4 were affected by chemotherapy or diet. Depletion of EPA is associated with pathways evoking enhanced TG accumulation in the liver. Restoring EPA through diet may pose a dietary strategy to attenuate chemotherapy-associated impediments in liver fatty acid metabolism.

Effect of L-carnitine supplementation on lipid accumulation product and cardiovascular indices in women with overweight/obesity who have knee osteoarthritis: a randomized controlled trial

Background

Osteoarthritis is associated with obesity, dyslipidemia and cardiovascular diseases. It has been hypothesized that L-carnitine can improve cardiovascular risk factors. We aimed to investigate the effect of L-carnitine supplementation on lipid accumulation product (LAP) and atherogenic indices in women with overweight/obesity who have knee osteoarthritis.

Methods

In this double-blind randomized controlled trial, seventy-six women with overweight/obesity who had knee osteoarthritis were assigned into the intervention group and control group for 12 weeks. The intervention group received 1000 mg/day L-carnitine as capsule, and the control group received placebo. The primary outcomes were LAP, atherogenic index of plasma (AIP), atherogenic coefficient (AC) and Castelli risk index II (CRI-II).

Results

We found no significant difference between the groups in baseline values of LAP, AIP, AC and CRI-II. After the intervention, a significant reduction in LAP was observed in intervention group compared to the control group (− 11.05 (− 28.24 to 0.40) vs. − 5.82 (− 24.44 to 2.68); P = 0.03). However, there was no significant difference between two groups in AIP (− 0.05 ± 0.16 vs. − 0.01 ± 0.13; P = 0.19), AC (− 0.40 ± 0.81 vs. − 0.30 ± 0.67; P = 0.67) and CRI-II (− 0.20 ± 0.76 vs. − 0.21 ± 0.47; P = 0.11).

Conclusions

L-carnitine supplementation for 12 weeks can improve LAP, but it has no effect on cardiovascular outcomes. To reach a definitive conclusion, further clinical trials with larger sample sizes and higher dosages of L-carnitine are needed.

Trial registration

Registered on 27/4/2017 at Iranian Registry of Clinical Trials IRCT2017011932026N2.

Effect of resveratrol supplementation on hepatic steatosis and cardiovascular indices in overweight subjects with type 2 diabetes: a double-blind, randomized controlled trial

BACKGROUND

Patients with type 2 diabetes mellitus (T2DM) are prone to develop non-alcoholic fatty liver disease (NAFLD) and cardiovascular diseases (CVD). We aimed to investigate whether the resveratrol supplementation improves novel hepatic and cardiovascular indices in these patients.

METHODS

We conducted a double-blind, randomized controlled trial for 8 weeks. Seventy-six patients with T2DM were randomly assigned to receive 1000 mg/day resveratrol or placebo. Levels of lipid accumulation product (LAP), visceral adiposity index (VAI), Castelli risk index I (CRI-I), CRI-II and atherogenic coefficient (AC) were measured at the beginning and after intervention.

RESULTS

A total of 71 participants completed the trial. After adjusting for confounding factors including medications, diabetes duration, energy intake and physical activity, no significant difference was found between the intervention group and the control group in LAP (mean change: - 2.46 ± 23.3 vs. 1.43 ± 14.3; P = 0.43), VAI (mean change: - 0.25 ± 1.1 vs. - 0.02 ± 0.6; P = 0.47), CRI-I (mean change: - 0.25 ± 0.9 vs. - 0.09 ± 0.5; P = 0.79), CRI-II (mean change: - 0.23 ± 0.7 vs. - 0.06 ± 0.6; P = 0.38) and AC (mean change: - 0.25 ± 0.9 vs. - 0.09 ± 0.5; P = 0.79).

CONCLUSIONS

Resveratrol supplementation had no effect on hepatic steatosis and cardiovascular indices. Further clinical trials, especially among subjects with dyslipidemia are needed to reach a firm conclusion. In addition, taking all medications should be controlled in future studies. Trial registration The protocol was registered on 29/12/2017 at the Iranian clinical trials website (IRCT20171118037528N1) with URL: https://en.irct.ir/trial/27734 .

Effect of omega-3 supplementation on cardiometabolic indices in diabetic patients with non-alcoholic fatty liver disease: a randomized controlled trial

Background

Patients with non-alcoholic fatty liver disease (NAFLD) as well as type 2 diabetes mellitus (T2DM) are at increased risk for cardiovascular diseases (CVD). Omega-3 supplementation has been proposed as a possible strategy for management of cardiometabolic risk. Cardiometabolic indices can predict and evaluate the cardiometabolic risk.

Aims

We investigated the effect of omega-3 supplementation on accurate and available cardiometabolic indices including atherogenic index of plasma (AIP), Castelli risk index I, Castelli risk index II and atherogenic coefficient (AC) in diabetic patients with NAFLD.

Methods

We conducted a double-blind, randomized controlled trial (RCT) for 12 weeks. From August 2016 to March 2017, the subjects referred to Faghihi hospital in Shiraz, Iran, were recruited. Sixty diabetic patients with NAFLD were randomly assigned into the omega-3 (2000 mg/d omega-3 capsule contained 360 mg/d eicosapentaenoic acid and 240 mg/d docosahexaenoic acid) and the placebo (liquid paraffin) groups using computer-generated random number table.

Results

Omega-3 supplementation compared to the placebo had no significant effect on AIP (− 0.11 ± 0.20 vs. -0.03 ± 0.16; P = 0.11), Castelli risk index I (− 0.25 ± 0.6 vs. -0.07 ± 0.7; P = 0.42), Castelli risk index II (− 0.24 ± 0.5 vs. -0.14 ± 0.5; P = 0.63) and AC (− 0.25 ± 0.6 vs. -0.07 ± 0.7; P = 0.42). After adjusting for confounding factors, the findings remained without change.

Conclusion

Omega-3 supplementation (2000 mg/d) for 12 weeks has no effect on cardiometabolic risk. It seems, higher doses of omega-3 can improve cordiometabolic risk. The trial was registered at Iranian Registry of Clinical Trials IRCT2016102530489N1.

Diet and Gut Microbiota Interaction-Derived Metabolites and Intrahepatic Immune Response in NAFLD Development and Treatment

Nonalcoholic fatty liver disease (NAFLD) with pathogenesis ranging from nonalcoholic fatty liver (NAFL) to the advanced form of nonalcoholic steatohepatitis (NASH) affects about 25% of the global population. NAFLD is a chronic liver disease associated with obesity, type 2 diabetes, and metabolic syndrome, which is the most increasing factor that causes hepatocellular carcinoma (HCC). Although advanced progress has been made in exploring the pathogenesis of NAFLD and penitential therapeutic targets, no therapeutic agent has been approved by Food and Drug Administration (FDA) in the United States. Gut microbiota-derived components and metabolites play pivotal roles in shaping intrahepatic immunity during the progression of NAFLD or NASH. With the advance of techniques, such as single-cell RNA sequencing (scRNA-seq), each subtype of immune cells in the liver has been studied to explore their roles in the pathogenesis of NAFLD. In addition, new molecules involved in gut microbiota-mediated effects on NAFLD are found. Based on these findings, we first summarized the interaction of diet-gut microbiota-derived metabolites and activation of intrahepatic immunity during NAFLD development and progression. Treatment options by targeting gut microbiota and important molecular signaling pathways are then discussed. Finally, undergoing clinical trials are selected to present the potential application of treatments against NAFLD or NASH.