Table 2.

The relationship between dietary fish and long-chain omega-3 fatty acid intake, and histological features of nonalcoholic fatty liver disease

Histological Parameter	n	Fish (oz / mo)	LCn-3 (mg / d)
Diagnosis
Steatosis	55	4.4 (0.7–13.6)	45 (23–83)
Borderline, Zone 1	42	3.3 (0.0–8.0)	48 (27–72)
Borderline, Zone 3	50	3.0 (0.0–25.0)	40 (27–117)
Definite NASH	76	6.0 (1.1–14.4)	40 (26–80)
Crude		p = 0.39	p = 0.90
Adjusted		p = 0.38	p = 0.97
Portal Inflammation
None	20	11.7 (4.7–19.8)	57 (36–110)
Mild	181	4.3 (0.7–13.1)	44 (26–78)
More than Mild	22	2.9 (0.0–5.9)	33 (23–102)
Crude		p = 0.02	p = 0.22
Adjusted		p = 0.03	p = 0.10
Lobular Inflammation
<2 Foci / 200x Field	116	4.4 (0.7–16.1)	48 (26–81)
2–4 Foci / 200x Field	94	5.3 (1.4–13.0)	43 (28–80)
>4 Foci / 200x Field	13	0.0 (0.0–5.8)	29 (11–41)
Crude		p = 0.08	p = 0.13
Adjusted		p = 0.09	p = 0.004

Legend: Zones 1 and 3 refer to the periportal and centrilobular zones of the liver, respectively. Intake of fish and long-chain omega-3 fatty acids are reported for each level of the histological parameters as a median with interquartile range in parentheses. Crude analysis using Kruskal-Wallis test to assess differences in dietary variables across levels of portal and lobular inflammation, and Wilcoxon's rank-sum test to compare dietary variables of subjects diagnosed with steatosis and definite nonalcoholic steatohepatitis. Multivariate analysis of variance (MANOVA) controlling for age, gender, ethnicity, BMI z-score, and intake of energy, carbohydrates, protein, total, saturated, monounsaturated and polyunsaturated fat, sugar, fiber, cholesterol, vitamins A, C and E, β-carotene, betaine and choline was used for the adjusted analysis. Dietary variables were determined to be non-normally distributed using Shapiro-Wilk test and analysis of frequency distribution graphs, and were log-transformed for the MANOVA. Fish intake was entered as log (fish intake + 1) to accommodate zero values. LCn3 = long-chain omega-3 fatty acids, NASH = nonalcoholic steatohepatitis.