Docosahexaenoic acid supplementation decreases liver fat content in children with non-alcoholic fatty liver disease: double-blind randomised controlled clinical trial
- Valerio Nobili1,
- Giorgio Bedogni2,3,
- Anna Alisi1,
- Andrea Pietrobattista1,
- Patrizia Risé4,
- Claudio Galli4,
- Carlo Agostoni3
- 1Unit of Metabolic and Autoimmune Liver Diseases, “Bambino Gesù” Children's Hospital – IRCCS, Rome, Italy
- 2Clinical Epidemiology Unit, Liver Research Center, Basovizza, Trieste, Italy
- 3Department of Maternal and Pediatric Sciences, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
- 4Department of Pharmacological Sciences, University of Milan, Milan, Italy
- Correspondence to Dr Valerio Nobili, Unit of Metabolic and Autoimmune Liver Diseases, “Bambino Gesù” Children's Hospital – IRCCS, Square S Onofrio 4, 00165 Rome, Italy;
Contributions Study guarantor: VN; study concept and design: VN, GB, CA; acquisition of clinical data: AA, AP; analysis and processing of fatty acid data: PR, CG; statistical analysis: GB; interpretation of data: GB, VN, CA; drafting of the manuscript: VN, GB, CA; obtained funding: VN; administrative, technical or material support: DMF (Lainate, Italy) provided DHA and placebo pills.
- Accepted 8 November 2010
- Published Online First 12 January 2011
Objective To investigate whether dietary supplementation with docosahexaenoic acid (DHA) decreases liver fat content in children with non-alcoholic fatty liver disease (NAFLD).
Design, setting and patients We performed a randomised controlled trial of DHA supplementation (250 and 500 mg/day) versus placebo in 60 children with biopsy-proven NAFLD (20 children per group).
Main outcome measures The main outcome was the change in liver fat content as detected by ultrasonography after 6 months of treatment. Secondary outcomes were the changes in insulin sensitivity index, alanine transaminase, triglycerides and body mass index after 6 months of treatment.
Results Blood DHA increased in children supplemented with DHA (0.65%, 95% CI 0.30% to 1.10% for the DHA 250 mg group and 1.15%, 0.87% to 1.43% for the DHA 500 mg group). The odds of more severe versus less severe liver steatosis after treatment was lower in children treated with DHA 250 mg/day (OR = 0.01, 0.002 to 0.11, p <0.001) and DHA 500 mg/day (OR = 0.04, 0.002 to 0.46, p = 0.01) as compared to placebo but there was no difference between the DHA groups (p = 0.4). Insulin sensitivity index increased and triglycerides decreased to a similar degree in both DHA groups as compared to placebo but there was no effect on alanine transaminase and body mass index.
Conclusion DHA supplementation improves liver steatosis and insulin sensitivity in children with NAFLD.
Funding The study was supported by the ‘Bambino Gesù’ Children Hospital.
Competing interests None.
Ethics approval This study was conducted at Pediatric Hospital Bambino Gesù, Rome, Italy.
Provenance and peer review Not commissioned; externally peer reviewed.