A systematic review and meta-analysis of randomized controlled trials to evaluate plant-based omega-3 polyunsaturated fatty acids in nonalcoholic fatty liver disease patient biomarkers and parameters.

46 , 47 , 51 , 56 Effect on glycemic-control biomarkers Glucose and insulin The pooled estimate on the effects of plant-based n-3 fatty acids on blood glucose and insulin from 4 studies showed a marginally significant ( P = 0.09) pooled effect for glucose (MD: −1.80 mg/dL; 95% CI: −3.85, 0.25; I 2 = 75.92%) and was nonsignificant for insulin (MD: −0.50 μU/mL; 95% CI: −1.59, 0.59; I 2 = 16.12%) for the included studies, which accounted for 2 adult flaxseed ALA interventions 46 , 51 (58 patients) and 2 child/adolescent (43 patients) DHA trials 53 , 56 ( Table 5 , 46 , 47 , 51–56 Figure 5A , 46 , 51 , 53 , 56 and Figure 5B 46 , 47 , 51 , 53 , 54 , 56 ).

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61 The marginal significance obtained for blood glucose ( P = 0.09) and HOMA-IR ( P = 0.07) could result from a small sample size and short-term study durations and, although not statistically significant, should be interpreted with caution.

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34 , 41 The molecular mechanisms causing the initiation and progression of NAFLD have yet to be fully recognized and understood; however, inflammation and oxidative stress induced by reactive oxygen species are likely to be significant mechanisms that can lead to hepatic cell death and tissue injury. 80 NAFLD is usually believed to have a mutual and bidirectional nexus with metabolic syndrome and its individual components and, therefore, to be a noncommunicable disease.

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