Omega-3 polyunsaturated fatty acids in the treatment of non-alcoholic fatty liver disease: An umbrella systematic review and meta-analysis

Abstract

There has been conflicting evidence from meta-analyses on the effect of polyunsaturated fatty acids (PUFA) on non-alcoholic fatty liver disease (NAFLD). Therefore, in this umbrella meta-analysis, we are evaluating whether omega-3 PUFA supplementation has any benefit in treating NAFLD. Electronic databases such as PubMed, Web of Science, Scopus, Embase and Google Scholar were assessed to October 2022. This meta-analysis included all meta-analyses that examined the effect of PUFAs on liver fat and liver function tests [aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyl transferase (GGT)]. Meta-analysis was conducted using a random effects model. Subgroup analyses and sensitivity analyses were also performed. In total, eight articles involving 6,561 participants met the eligibility criteria. Advantageous impacts PUFA supplementation were observed on ALT (ES_WMD = -6.72 IU/L; 95% CI: -8.61, -4.84; p < 0.001, and ES_SMD = -0.52 IU/L; 95% CI: -0.84, -0.20, p < 0.001), AST (ES_WMD = -3.73 IU/L, 95% CI: -5.93, -1.53, p < 0.001, and ES_SMD = -0.65 IU/L; 95% CI: -1.08, -0.22, p = 0.003), GGT levels (ES_WMD = -4.20 IU/L, 95% CI: -6.85, -1.55, p = 0.002), and liver fat (ES_WMD = -5.16; 95% CI: -8.49, -1.82, p < 0.001). Intervention with omega-3 PUFAs improves ALT, AST, GGT, and liver fat in patients with NAFLD. Thus, omega-3 PUFAs could be considered as a therapeutic option in the treatment of NAFLD.

Keywords: liver enzyme; meta-analyses; non-alcoholic fatty liver disease; omega-3 polyunsaturated fatty acids.