N-3 Polyunsaturated Fatty Acid Supplementation Reduces Insulin Resistance In Hepatitis C Virus Infected Patients: A Randomised Controlled Trial

BackgroundInsulin resistance promotes liver disease progression and may be associated with a lower response rate in treated hepatitis C virus (HCV) infected patients. n-3 polyunsaturated fatty acid (PUFA) supplementation may reduce insulin resistance.The present study aimed to evaluate the effect of n-3 PUFA supplementation on insulin resistance in these patients.MethodsIn a randomised, double-blind clinical trial, 154 patients were screened. After applying inclusion criteria, 52 patients [homeostasis model assessment index of insulin resistance (HOMA-IR2.5)] were randomly divided into two groups: n-3 PUFA (n=25/6000mgday(-1) of fish oil) or control (n=27/6000mgday(-1) of soybean oil). Both groups were supplemented for 12weeks and underwent monthly nutritional consultation. Biochemical tests were performed at baseline and after intervention. Statistical analysis was performed using the Wilcoxon Mann-Whitney test for comparisons and the Wilcoxon test for paired data. Statistical package r, version 3.02 (The R Project for Statistical Computing) was used and P<0.05 (two-tailed) was considered statistically significant.ResultsComparisons between groups showed that n-3 PUFA supplementation was more effective than the control for reducing HOMA-IR (P=0.015) and serum insulin (P=0.016). The n-3 PUFA group not only showed a significant reduction in HOMA-IR 3.8 (3.2-5.0) versus 2.4 (1.8-3.3) (P=0.002); serum insulin 17.1 (13.8-20.6)IUmL(-1) versus 10.9 (8.6-14.6)IUmL(-1) (P=0.001); and glycated haemoglobin 5.4% (5.0-5.7%) versus 5.1% (4.8-5.6%) (P=0.011), but also presented an increase in interleukin-1 97.5 (0.0-199.8)pgmL(-1) versus 192.4 (102.2-266.8)pgmL(-1) (P=0.003) and tumour necrosis factor 121.2 (0.0-171.3)pgmL(-1) versus 185.7 (98.0-246.9) pgmL(-1) (P=0.003).Conclusionsn-3 PUFA supplementation reduces insulin resistance in genotype 1 HCV infected patients.