Beneficios de los ácidos grasos poliinsaturados de cadena larga n-3 en la enfermedad por hígado graso no alcohólico / Benefits of n-3 long-chain polyunsaturated fatty acids in non-alcoholic fatty liver disease

La enfermedad por hígado graso no alcohólico (EHGNA) se asocia comúnmente con las características clínicas del síndrome metabólico como la obesidad, resistencia a la insulina y dislipidemia. La importancia clínica se debe a su elevada prevalencia (30% de la población general) y su amplio espectro de daño histológico que va desde la esteatosis simple generalmente no progresiva, a la esteatohepatitis no alcohólica, que puede conducir a cirrosis, carcinoma hepatocelular, e insuficiencia hepática. En la actualidad, se han caracterizado diferentes factores que conllevan a esta enfermedad hepática, destacándose principalmente el alto contenido de ácidos grasos libres y la resistencia a insulina. El exceso de ácidos grasos libres puede desencadenar lipotoxicidad hepática originada por un alto consumo de ácidos grasos saturados, ácidos grasos trans y carbohidratos, así como por un aumento de los radicales libres y del estrés del retículo endoplásmico. En lo que concierne a los ácidos grasos poliinsaturados de cadena larga n-3 (AGPICL n-3), se han atribuido múltiples beneficios para la salud humana. Los AGPICL n-3 EPA y DHA tienen efectos protectores en la salud cardiovascular y en la funcionalidad e integridad del sistema nervioso central. Actualmente el uso nutricional de ambos ácidos grasos es cada vez más amplio, atribuyendo sus efectos positivos no solamente al tratamiento de las enfermedades cardiovasculares y neurodegenerativas, sino también considerándolos una alternativa eficaz en el manejo de nutricional de la EHGNA. El presente trabajo analiza el uso potencial de los AGPICL n-3 en la prevención y manejo nutricional de la EHGNA.

Nonalcoholic fatty liver disease (NAFLD) is commonly associated with the clinical features of the metabolic syndrome including obesity, insulin resistance and dyslipidemia. NAFLD. Is of clinical relevance because its high prevalence (30% of the general population) and broad spectrum of histological damage, ranging from simple steatosis that is generally non progressive, to nonalcoholic steatohepatitis which can lead to cirrhosis, hepatoce-llular carcinoma, and liver failure. At present, different factors have been identified that lead to this liver disease, highlighting the high content of free fatty acids and insulin resistance. In this regard, excess of free fatty acids caused by a high intake of sa-turated fatty acids, trans fatty acids and of carbohydrates as well the increased formation free radicals that stress the endoplasmic reticulum, can trigger liver lipotoxicity. Regarding fatty acids, n-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA) have been associated to many benefits for human health. n-3 LCPUFA, such as EPA and DHA, have protective roles in cardiovascular health and in the functionality and integrity of the central nervous system. Currently, the possible therapeutic uses of these fatty acids is expanding, attributing their positive effects not only for the treatment of cardiovascular and neurodegenerative diseases, but also seeing it as an effective alternative in the management of NAFLD. The present review analyzes the potential use of n-3 LCPUFA in the treatment and protection of NAFLD.

Reducción de la esteatosis hepática, insulino resistencia y pérdida de la defensa antioxidante en ratones alimentados con dieta alta en grasa suplementados con AGPICL n-3 más aceite de oliva extra virgen / Reduction of hepatic steatosis, insulin resistance and loss of antioxidant defense in high fat diet fed mice suplemented with n-3 LCPUFA more extra virgin olive oil

Non-alcoholic fatty liver disease (NAFLD) is directly associated with insulin resistance and oxidative stress. In NAFLD is established a reduction in n-3 LCPUFA (EPA + DHA) levels and hepatic activity of transcription factor PPAR-alpha. EPA and DHA inhibit lipogenesis and stimulate fatty acid oxidation in the liver. Extra virgin olive oil (EVOO) has important antioxidant properties. This study evaluated the prevention of insulin resistance and prevention of depletion of hepatic antioxidant defense inC57BL/6J mice fed high-fat diet (HFD), supplemented with n-3 LCPUFA plus EVOO. HFD generated insulin resistance and hepatic steatosis, together with significant reduction in i) n-3 LCPUFA hepatic levels, ii) DNA binding activity of PPAR-alpha, iii) activity of antioxidant enzymes (catalase and superoxide dismutase), respect to control group (fed with control diet). Supplementation with n-3 LCPUFA plus EVOO prevent development insulin resistance and attenuate increased of fat in liver (p < 0.05), together with a normalization of i) DNA binding activity of PPAR-á, ii) activity of antioxidant enzymes (catalase and superoxide dismutase) and iii) reducing depletion of n-3 LCPUFA levels in liver tissue, compared to the control group (p < 0.05). Supplementation with n-3 LCPUFA plus EVOO reduced hepatic steatosis and prevent development of insulin resistance, along with preserving the antioxidant defense in liver. Projecting the use of this mixture of AGPICL n-3 plus EVOO as a potential treatment of NAFLD.