Highly purified eicosapentaenoic acid treatment improves nonalcoholic steatohepatitis

被引:209
作者
Tanaka, Naoki [1 ,2 ]
Sano, Kenji [3 ]
Horiuchi, Akira [4 ]
Tanaka, Eiji [2 ]
Kiyosawa, Kendo [2 ]
Aoyama, Toshifumi [1 ]
机构
[1] Shinshu Univ, Dept Metab Regulat, Grad Sch Med, Matsumoto, Nagano 3908621, Japan
[2] Shinshu Univ, Sch Med, Dept Gastroenterol, Nagano, Japan
[3] Shinshu Univ Hosp, Dept Lab Med, Matsumoto, Nagano, Japan
[4] Showa Inan Gen Hosp, Dept Gastroenterol, Nagano, Japan
关键词
alanine aminotransferase; free fatty acids; oxidative stress; soluble tumor necrosis factor receptors; ferritin;
D O I
10.1097/MCG.0b013e31815591aa
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Recent studies have demonstrated that n-3 polyunsaturated fatty acids ameliorate nonalcoholic fatty liver disease. Although eicosapentaenoic acid (EPA), one of the major components of n-3 polyunsaturated fatty acids, is widely used as an antilipidemic agent, its single efficacy for nonalcoholic steatohepatitis (NASH) remains unclear. As such, we aimed to evaluate the efficacy and safety of EPA on 23 biopsy-proven NASH patients in a pilot trial. Highly purified EPA (2700 mg/d) was administered for 12 months and efficacy was assessed by biochemical parameters and liver histology. All patients completed the treatment with no adverse events, indicating acceptable tolerance to the treatment. After 12 months, serum alanine amino transferase levels were significantly improved (from 79 36 to 50 120 U/L), and serum free fatty acids, plasma soluble tumor necrosis factor receptor 1 and 2 levels, and serum ferritin and thioredoxin levels, which may reflect hepatic oxidative stress, were significantly decreased. Body weight, blood glucose, insulin, and adiponectin concentrations remained unchanged. Seven of the 23 patients consented to undergo posttreatment liver biopsy, which showed improvement of hepatic steatosis and fibrosis, hepatocyte ballooning, and lobular inflammation in 6 patients. In conclusion, EPA treatment seems to be safe and efficacious for patients with NASH, largely due to its anti-inflammatory and antioxidative properties. To confirm these results, appropriately powered, controlled trials are needed.
引用
收藏
页码:413 / 418
页数:6
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