BOSTON, MA—Omega-3 fatty acids are associated with a significant reduction in liver fat in patients with hepatic steatosis, a systematic review and meta-analysis presented at The Liver Meeting® 2016 has found.

“With their safety profile, omega-3 fatty acid supplementation may be beneficial for reducing hepatic steatosis and improve dyslipidemia and, subsequently, cardiovascular risk,” noted Devika Kapuria, MD, of the department of internal medicine at the University of Missouri-Kansas City, Kansas City, MO.

Dr. Kapuria and colleagues noted that the prevalence of non-alcoholic fatty live disease (NAFLD) may correlate with a deficiency of omega-3 fatty acids, an excess of omega-6 fatty acids, and refined carbohydrates in Western diets, all of which are associated with coronary artery disease and metabolic syndrome.

Recently, a favorable change in liver fat with long-term omega-3 fatty acid supplementation has been reported. To study this effect on hepatic steatosis and serum markers of NAFLD, the investigators conducted a meta-analysis using data from studies identified on Medline, Embase, and Ovid databases from 1996–2016.

“Primary analysis was performed on effect of omega-3-fatty acids on hepatic steatosis; effect size was calculated using standardizing mean difference,” they noted. In addition, subgroup analyses were performed to evaluate effect on alanine aminotransferase (ALT), serum triglycerides, and homeostatic model assessment for insulin resistance (HOMA-IR).

A total of 715 studies were identified, 10 of which were included in the final analysis, 4 randomized controlled trials and 6 observational studies. Of the 547 patients included in the pooled analysis, 286 were administered omega-3 fatty acids at a dose ranging between 2–4g/day for 8 weeks to 18 months; 261 patients served as controls.

For all studies, the standard mean difference was -0.81 (95% CI: -1.35, -0.28), favoring the omega-3-fatty acids arm vs. placebo. The effect of omega-3 fatty acids vs. placebo on hepatic steatosis showed a mean difference of -7.64 (-14.27, -1.00) on serum ALT levels and -45.97 (-58.29, -33.65) on serum triglyceride levels. An improvement in IR was also observed.

“There is conflicting data regarding possible reduction in hepatic fibrosis, inflammation, and ballooning, possibly because of a variance in dose and duration of treatment,” the study investigators noted. “Limitations to these studies include a lack of more sensitive methods for liver fat, including magnetic resonance spectroscopy.”

They noted that their results compared favorably with other interventions, including metformin, simvastatin, ursodeoxycholic acid, and betaine.

“Further trials are required to establish optimal dosing, duration of therapy, and methods for quantification of liver fat,” they concluded.