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Omega-3 phospholipids and obesity-associated NAFLD: Potential mechanisms and therapeutic perspectives
European Journal of Clinical Investigation ( IF 4.4 ) Pub Date : 2021-07-22 , DOI: 10.1111/eci.13650
Marko Mitrovic 1 , Gabriella Sistilli 1 , Olga Horakova 1 , Martin Rossmeisl 1
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Prevalence of non-alcoholic fatty liver disease (NAFLD) increases in line with obesity and type 2 diabetes, and there is no approved drug therapy. Polyunsaturated fatty acids of n-3 series (omega-3) are known for their hypolipidaemic and anti-inflammatory effects. Existing clinical trials suggest varying effectiveness of triacylglycerol- or ethyl ester-bound omega-3 in the treatment of NAFLD, without affecting advanced stages such as non-alcoholic steatohepatitis. Preclinical studies suggest that the lipid class used to supplement omega-3 may determine the extent and nature of their effects on metabolism. Phospholipids of marine origin represent an alternative source of omega-3. The aim of this review is to summarise the available evidence on the use of omega-3 phospholipids, primarily in obesity-related NAFLD, and to outline perspectives of their use in the prevention/treatment of NAFLD. A PubMed literature search was conducted in May 2021. In total, 1088 articles were identified, but based on selection criteria, 38 original papers were included in the review. Selected articles describing the potential mechanisms of action of omega-3 phospholipids have also been included. Preclinical evidence clearly indicates that omega-3 phospholipids have strong antisteatotic effects in the liver, which are stronger compared to omega-3 administered as triacylglycerols. Multiple mechanisms are likely involved in the overall antisteatotic effects, involving not only the liver but also adipose tissue and the gut. Robust preclinical evidence for strong antisteatotic effects of omega-3 phospholipids in the liver should be confirmed in clinical trials. Further research is needed on the possible effects of omega-3 phospholipids on advanced NAFLD.

中文翻译:

Omega-3 磷脂和肥胖相关的 NAFLD:潜在机制和治疗前景

非酒精性脂肪性肝病 (NAFLD) 的患病率随着肥胖和 2 型糖尿病的增加而增加,并且没有批准的药物治疗。n的多不饱和脂肪酸-3 系列 (omega-3) 以其降血脂和抗炎作用而闻名。现有的临床试验表明,三酰基甘油或乙酯结合的 omega-3 在治疗 NAFLD 中的效果不同,而不会影响非酒精性脂肪性肝炎等晚期阶段。临床前研究表明,用于补充 omega-3 的脂质类别可能决定其对新陈代谢影响的程度和性质。海洋来源的磷脂代表了 omega-3 的替代来源。本综述的目的是总结关于使用 omega-3 磷脂的现有证据,主要用于肥胖相关的 NAFLD,并概述其在预防/治疗 NAFLD 中的应用前景。2021 年 5 月进行了 PubMed 文献检索。总共确定了 1088 篇文章,但基于选择标准,38篇原创论文被纳入评审。还包括描述 omega-3 磷脂潜在作用机制的精选文章。临床前证据清楚地表明,omega-3 磷脂在肝脏中具有很强的抗脂肪变性作用,与以三酰基甘油形式给药的 omega-3 相比,这种作用更强。多种机制可能涉及整体抗脂肪变性作用,不仅涉及肝脏,还涉及脂肪组织和肠道。应在临床试验中证实 omega-3 磷脂在肝脏中具有强抗脂肪作用的强有力的临床前证据。需要进一步研究 omega-3 磷脂对晚期 NAFLD 的可能影响。还包括描述 omega-3 磷脂潜在作用机制的精选文章。临床前证据清楚地表明,omega-3 磷脂在肝脏中具有很强的抗脂肪变性作用,与以三酰基甘油形式给药的 omega-3 相比,这种作用更强。多种机制可能涉及整体抗脂肪变性作用,不仅涉及肝脏,还涉及脂肪组织和肠道。应在临床试验中证实 omega-3 磷脂在肝脏中具有强抗脂肪作用的强有力的临床前证据。需要进一步研究 omega-3 磷脂对晚期 NAFLD 的可能影响。还包括描述 omega-3 磷脂潜在作用机制的精选文章。临床前证据清楚地表明,omega-3 磷脂在肝脏中具有很强的抗脂肪变性作用,与以三酰基甘油形式给药的 omega-3 相比,这种作用更强。多种机制可能涉及整体抗脂肪变性作用,不仅涉及肝脏,还涉及脂肪组织和肠道。应在临床试验中证实 omega-3 磷脂在肝脏中具有强抗脂肪作用的强有力的临床前证据。需要进一步研究 omega-3 磷脂对晚期 NAFLD 的可能影响。与以三酰基甘油形式给药的 omega-3 相比更强。多种机制可能涉及整体抗脂肪变性作用,不仅涉及肝脏,还涉及脂肪组织和肠道。应在临床试验中证实 omega-3 磷脂在肝脏中具有强抗脂肪作用的强有力的临床前证据。需要进一步研究 omega-3 磷脂对晚期 NAFLD 的可能影响。与以三酰基甘油形式给药的 omega-3 相比更强。多种机制可能涉及整体抗脂肪变性作用,不仅涉及肝脏,还涉及脂肪组织和肠道。应在临床试验中证实 omega-3 磷脂在肝脏中具有强抗脂肪作用的强有力的临床前证据。需要进一步研究 omega-3 磷脂对晚期 NAFLD 的可能影响。
更新日期:2021-07-22
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