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Omega-3 Fatty Acid Supplementation Decreases Liver Fat Content in Polycystic Ovary Syndrome: A Randomized Controlled Trial Employing Proton Magnetic Resonance Spectroscopy

University of Western Australia (A.J.C., G.F.W., T.A.M., B.G.A.S.), School of Medicine and Pharmacology, Royal Perth Hospital, Perth 6847, Western Australia; Keogh Institute for Medical Research (B.G.A.S.), Nedlands 6009, Western Australia; Department of Endocrinology and Diabetes (A.J.C.), Royal Perth Hospital, Perth 6847, Western Australia; and Department of Endocrinology and Diabetes (B.G.A.S.), Sir Charles Gairdner Hospital, Nedlands 6009, Western Australia

Address all correspondence and requests for reprints to: Dr. Andrea J. Cussons, School of Medicine and Pharmacology, Royal Perth Hospital Unit, GPO Box X2213, Perth, Western Australia 6847. E-mail: acussons{at}meddent.uwa.edu.au.

Context: There is an association between nonalcoholic fatty liver disease (NAFLD) and the polycystic ovary syndrome (PCOS). Marine-derived omega-3 fatty acids have favorable effects on cardiovascular risk and could reduce liver fat in NAFLD.

Objective: The primary aim of this study was to examine the effects of omega-3 fatty acids on liver fat in PCOS. The secondary aim was to assess their effects on traditional cardiovascular risk factors.

Design and Setting: We conducted a randomized, crossover study at a tertiary cardiovascular research center.

Subjects: Twenty-five women with PCOS (mean age, 32.7 yr; mean body mass index, 34.8 kg/m²) participated in the study.

Intervention: We compared 4g/d of omega-3 fatty acids with placebo over 8 wk.

Main Outcome Measures: The primary outcome measure was hepatic fat content quantified using proton magnetic resonance spectroscopy. Secondary outcome measures included fasting lipids and blood pressure.

Results: Omega-3 fatty acids significantly decreased liver fat content compared with placebo [10.2 (1.1) vs. 8.4 (0.9)%; P = 0.022]. There was also a reduction in triglycerides [1.19 (1.03–1.47) vs. 1.02 (0.93–1.18) mmol/liter; P = 0.002], systolic blood pressure [124.1 (12.1) vs. 122.3 (14.5) mm Hg; P = 0.018], and diastolic blood pressure [73.2 (8.4) vs. 69.7 (8.3) mm Hg; P = 0.005] with omega-3 fatty acids compared with placebo. Omega-3 fatty acids particularly decreased hepatic fat in women with hepatic steatosis, defined as liver fat percentage greater than 5% [18.2 (11.1) vs. 14.8 (9.3)%; P = 0.03].

Conclusions: Omega-3 fatty acid supplementation has a beneficial effect on liver fat content and other cardiovascular risk factors in women with PCOS, including those with hepatic steatosis. Whether this translates into a reduction in cardiometabolic events warrants further study.