Table 2.

Clinical trials on the effects of n-3 PUFA on NAFLD in individuals at high cardiometabolic risk.

Author (Reference)	Study Design	Study Population Participants Age BMI	Intervention and Doses	Duration Weeks	Observed Effects with n-3 PUFA
					Liver Imaging	Liver Biomarkers	Liver Scores	Liver Biopsy
Spadaro et al., 2008 [66]	Parallel group randomized, controlled	36 M/F	2 g/day vs. placebo	24	↓ LIVER FAT (US)	AST =	n.a.	n.a.
		50.1 years				ALT ↓
		30.5 kg/m2
Scorletti et al., 2014 [67]	Double-blind, placebo-controlled	103 M/F	4 g/day (EPA 1.8 g, DHA 1.5 g) vs. placebo	72	↓ LIVER FAT (MRI)	AST =	n.a.	n.a.
		51.5 years				ALT =
		33.0 kg/m2
Zhu et al., 2008 [68]	Double-blind, placebo-controlled	134 M/F	6 g/day vs. placebo	24	↓ LIVER FAT (US)	AST =	n.a.	n.a.
		44.5 years				ALT ↓
		26.2 kg/m2
Vega et al., 2008 [69]	Crossover placebo-controlled	16 M/F	9 g/day (EPA 51.4%, DHA 23.9%) vs. placebo	8	= LIVER FAT (1H-MRS)	AST n.a.	n.a.	n.a.
		50.0 years				ALT n.a.
		36.2 kg/m2
Argo et al., 2015 [70]	Double-blind, placebo-controlled	34 M/F	3 g/day (EPA 35%, DHA 25%) vs. placebo	48	= LIVER FAT (MRI)	AST =	n.a.	= NASH score
		46.8 years				ALT =
		32.5 kg/m2
Sanyal et al., 2014 [71]	Double-blind, placebo-controlled	243 M/F	EPA 1.8 g/day vs. EPA 2.7 g/day vs. placebo	48	n.a.	AST =	n.a.	= NASH score
		48.7 years				ALT =
		34.8 kg/m2
Cussons et al., 2009 [72]	Crossover placebo-controlled	25 F	4 g/day (EPA 27%, DHA 56%) vs. placebo (oleic acid 67%)	8	= LIVER FAT (1H-MRS)	AST n.a.	n.a.	n.a.
		54.5 years				ALT =
		34.8 kg/m2

= no changes; ↓ significant decrease. BMI: body mass index; M: male; F: female; n-3 PUFA: n-3 polyunsaturated fatty acids; US: ultrasonography; n.a.: not assessed; MRI: magnetic resonance imaging; ALT: alanine aminotransferase; AST: aspartate aminotransferase; DHA: docosahexaenoic acid; EPA: eicosapentaenoic acid; ¹H-MRS: proton magnetic resonance spectroscopy; NASH: non-alcoholic steatohepatitis.