Nutritional assessment and hepatic fatty acid composition in non-alcoholic fatty liver disease (NAFLD): A cross-sectional study

Background/Aims Low hepatic n − 6 and n − 3 polyunsaturated fatty acid (PUFA) may contribute to steatosis and steatohepatitis and can be affected by diet and oxidative stress. Methods Seventy-three patients referred for elevated liver enzymes and suspected NAFLD were assessed. Nutritional assessment, hepatic FA composition and oxidative stress were compared between these groups: simple steatosis (SS, n = 18), steatohepatitis (NASH, n = 38) and minimal findings on liver biopsy (MF, n = 17). Results Patients with NASH had higher: BMI, central obesity, body fat, insulin resistance, dyslipidemia and lower physical activity compared to the other groups. They also had relatively lower hepatic n − 3 and n − 6 PUFA, a decrease in the ratio of metabolites to essential FA precursors for both n − 6 and n − 3 FA (eicosapentaenoic + docosahexaenoic/linolenic and arachidonic/linoleic acid ratios) and higher liver lipid peroxides with lower antioxidant power, when compared to MF. Overall, there was no significant difference between SS and NASH in FA composition. Self-reported dietary intake and red blood cell FA composition were similar among the three groups. Conclusions NASH patients have more metabolic abnormalities. This is associated with higher oxidative stress and lower n − 3 and n − 6 PUFA in the liver in the absence of any differences in dietary FA composition.