Long-term treatment with n-3 polyunsaturated fatty acids as a monotherapy in children with nonalcoholic fatty liver disease

Objective: to investigate the efficacy and safety of n-3 polyunsaturated fatty acids (pufa) treatment in obese children with nonalcoholic fatty liver disease (nafld). methods: one hundred and eight obese (body mass index (bmi) >95thpercentile for age and sex) adolescents with nafld were included in the study. mean age of the subjects was 13.8±3.9 years (9-17 yrs). the diagnosis of nafld was based on the presence of liver steatosis with high transaminases. the subjects were randomly divided into two groups. group 1 (pufa group,n=52) received a 1000 mg dose of pufa once daily for 12 months and lifestyle intervention. group 2 (placebo group,n=56) received a recommended diet plus placebo and lifestyle intervention for 12 months. insulin resistance was evaluated by homeostasis model assessment of insulin resistance (homa-ir) from fasting samples. results: bmi,fasting insulin levels and homa-ir values in both groups decreased significantly at the end of the study. in group 1,67.8% of the patients had a decrease from baseline in the prevalence of steatosis (p<0.001). frequency of elevated alanine aminotransferase (alt) levels (39.2% to 14.2%; p<0.01) and elevated aspartate aminotransferase (ast) levels (25% to 17.8%; p=0.01) decreased significantly in the pufa group. following a 12-month diet plus placebo and lifestyle intervention treatment,40.3% (21) of the patients in the placebo group also showed a decrease in frequency of steatosis (p=0.04) and slight decreases in frequency of elevated alt levels (38.4% to 28.8%; p=0.01) and ast levels (30.7% to 28.8%; p>0.05). conclusion: our results indicated that n-3 pufa treatment is safe and efficacious in obese children with nafld and can improve ultrasonographic findings and the elevated transaminase levels. © journal of clinical research in pediatric endocrinology,published by galenos publishing.