Docosahexaenoic acid enrichment in NAFLD is associated with improvements in hepatic metabolism and hepatic insulin sensitivity: a pilot study

作者：Hodson L^*; Bhatia L; Scorletti E; Smith D E; Jackson N C; Shojaee Moradie F; Umpleby M; Calder P C; Byrne C D

来源：European Journal of Clinical Nutrition, 2017, 71(8): 973-979.

DOI：10.1038/ejcn.2017.9

BACKGROUND/OBJECTIVE: Treatment of subjects with non-alcoholic fatty liver disease (NAFLD) with omega-3 polyunsaturated fatty acids (FAs) suggests high levels of docosahexaenoic acid (DHA) tissue enrichment decrease liver fat content. We assessed whether changes in erythrocyte DHA enrichment (as a surrogate marker of changes in tissue enrichment) were associated with alterations in hepatic de novo lipogenesis (DNL), postprandial FA partitioning and hepatic and peripheral insulin sensitivity in a sub-study of the WELCOME trial (Wessex Evaluation of fatty Liver and Cardiovascular markers in NAFLD (non-alcoholic fatty liver disease) with OMacor thErapy).
SUBJECTS/METHODS: Sixteen participants were randomised to 4 g/day EPA+DHA (n = 8) or placebo (n = 8) for 15-18 months and underwent pre-and post-intervention measurements. Fasting and postprandial hepatic FA metabolism was assessed using metabolic substrates labelled with stable-isotope tracers ((H2O)-H-2 and [(UC)-C-13] palmitate). Insulin sensitivity was measured by a stepped hyperinsulinaemic-euglycaemic clamp using deuterated glucose. Participants were stratified according to change in DHA erythrocyte enrichment (< or >= 2% post intervention).
RESULTS: Nine participants were stratified to DHA >= 2% (eight randomised to EPA+DHA and one to placebo) and seven to the DHA <2% group (all placebo). Compared with individuals with erythrocyte <2% change in DHA abundance, those with. 2% enrichment had significant improvements in hepatic insulin sensitivity, reduced fasting and postprandial plasma triglyceride concentrations, decreased fasting hepatic DNL, as well as greater appearance of C-13 from dietary fat into plasma 3-hydroxybutyrate (all P < 0.05).
CONCLUSIONS: The findings from our pilot study indicate that individuals who achieved a change in erythrocyte DHA enrichment. 2% show favourable changes in hepatic FA metabolism and insulin sensitivity, which may contribute to decreasing hepatic fat content.

• 出版日期2017-8