Clinical Trial: Omega 3 Supplementation in Fatty Liver

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Polyunsaturated Fatty Acid (Pufa) Omega 3 in the Reduction of the Inflammatory Component of the Nonalcoholic Steatohepatitis (Nash):Randomized Placebo Controlled Study

Brief Summary: Nonalcoholic fatty liver disease (NAFLD) is a clinical and pathological condition, whose spectrum can range from steatosis to steatohepatitis and cirrhosis, in patients without a history of alcohol abuse. Nonalcoholic steatohepatitis (NASH), the severe form of (NAFLD), has emerged as a clinically important type of chronic liver disease in industrialized countries and is characterized pathologically by hepatocellular ballooning, Mallory's hyaline, scattered inflammation and perisinusoidal fibrosis. NASH associated with cirrhosis can decompensate into subacute liver failure, progress to hepatocellular cancer and reoccur post transplantation.In the absence of established treatment, therapy is generally directed to treatment of risk factors for metabolic syndrome. Recently, some studies have been demonstrated that Polyunsaturated fatty acids (PUFAs), omega3 type, could reduced TNFalfa, IL6, aminotransferases, insulin resistance and steatosis verified by ultrasound. Neverthless, this is the first study that evaluate liver histology after six months of PUFA (omega3) in the treatment of patients with NASH.

Detailed Summary:

Nonalcoholic fatty liver disease (NAFLD) is a clinical and pathological condition, whose spectrum can range from steatosis to steatohepatitis and cirrhosis, in patients without a history of alcohol abuse. Nonalcoholic steatohepatitis (NASH), the severe form of (NAFLD), has emerged as a clinically important type of chronic liver disease in industrialized countries and is characterized pathologically by hepatocellular ballooning, Mallory's hyaline, scattered inflammation and perisinusoidal fibrosis. NASH associated with cirrhosis can decompensate into subacute liver failure, progress to hepatocellular cancer and reoccur post transplantation.

The 'two-hit' hypothesis has been proposed to explain the pathogenesis of NASH, with an initial metabolic disturbance (insulin resistance) causing steatosis and a second pathogenic stimulus promoting oxidative stress, increased generation of reactive oxygen species (ROS), lipid peroxidation, and resultant NASH . Insulin resistance plays a major role in hepatic fat accumulation through increased influx of free fatty acids (FFA) from peripheral fat stores due to enhanced lipolysis, increased de novo hepatocyte triglyceride synthesis from glucose and reduced apo B production, which diminishes fat export from the liver.

In the absence of established treatment, therapy is generally directed to treatment of risk factors for metabolic syndrome. Recently, some studies have been demonstrated that Polyunsaturated fatty acids (PUFAs), omega3 type, could reduced TNFalfa, IL6, aminotransferases, insulin resistance and steatosis verified by ultrasound. Nevertheless, this is the first study that evaluate liver histology after six months of PUFA (omega3) in the treatment of patients with NASH.

Based on these aspects, the aim of this prospective investiga
Sponsor: University of Sao Paulo General Hospital

Current Primary Outcome: Efficacy in reduce inflammatory component of NASH for NAS score [ Time Frame: 6 months ]

Determine the efficacy of Omega-3 fatty acid in reducing the inflammatory component of NASH for liver through liver biopsy NAS score.


Original Primary Outcome: Same as current

Current Secondary Outcome: Inflammatory systemic profile [ Time Frame: 6 mothns ]

Measure TNFalfa, IL6, adiponectin, lipidic leuckocyte profile, EPA (eicosapentaenoic acid), DHA (docosahexaenoic) and laboratory tests AST, ALT, Cholesterol, total triglycerides, PCR, VHS, SAA.


Original Secondary Outcome: Same as current

Information By: University of Sao Paulo General Hospital

Dates:
Date Received: November 7, 2013
Date Started: September 2009
Date Completion:
Last Updated: November 19, 2013
Last Verified: November 2013