Non-Alkolik Yağlı Karaciğer Hastalığında İnsülin Direnci, Oksidatif Stres ve Enflamasyon: D Vitamini ve Omega-3 Yağ Asitlerinin Etkileri

Öz

Non-alkolik yağlı karaciğer hastalığı (NAYKH), alkol tüketmeyen bireylerde karaciğerde aşırı yağ birikimi ile karakterize bir hastalıktır ve dünya çapında en yaygın kronik karaciğer hastalığı olarak tanımlanır. Yağ birikimi artan serbest yağ asitleri, hepatik de novo lipogenez artışı ve yüksek diyetsel yağ alımı ile ilişkilidir. NAYKH, basit steatozdan alkolsüz steatohepatite ve ilerleyen aşamalarda siroz, karaciğer yetmezliği ve hepatosellüler karsinomaya kadar ilerleyebilir. Bu hastalığın patogenezinde yer alan mekanizmalar net değildir. Ancak insülin direnci, oksidatif stres ve sistemik inflamasyon NAYKH patofizyolojisi ve şiddetinde önemli bir rol oynamaktadır. Bu derlemenin amacı NAYKH’nın risk faktörleri olan insülin direnci, oksidatif stres ve sistemik inflamasyon üzerinde D vitamini ve omega-3 yağ asitlerinin etkilerini özetlemektir. Son yıllarda, D vitamini ve omega-3 yağ asitleri diyabet ve kanser gibi birçok kronik hastalığın önlenmesi ve tedavisindeki yararlı etkileri nedeniyle dikkat çekmektedir. NAYKH tedavisi hâlâ tartışmalı bir konudur. Günümüzde ağırlık kaybı önerilen tek tedavi yöntemi olup, NAYKH’da yeni tedavi yaklaşımları araştırılmaktadır. İnsülin sensitizörleri, lipid düşürücü ilaçlar medikal tedavinin bir parçası olsa da omega-3 yağ asitleri ve D vitamini gibi bazı besin desteklerinin NAYKH için önleyici ve tedavi edici ajan olabileceği bildirilmektedir. Çeşitli çalışmalar, omega-3 ve D vitamini kullanımının inflamasyon belirteçlerini azalttığını ve karaciğer steatozunun düzelmesine katkı sağladığını göstermektedir. Bu iki biyoaktif bileşik, oksidatif stres ve inflamasyon üzerinde anti-inflamatuar ve antioksidan etki göstererek NAYKH için alternatif tedavi seçeneği olabilir.

Anahtar Kelimeler

• D vitamini
• İnflamasyon
• İnsülin direnci
• Non-alkolik yağlı karaciğer hastalığı
• Oksidatif stres
• Omega-3 yağ asitleri

Insulin Resistance, Oxidative Stress, and Inflammation in Non-Alcoholic Fatty Liver Disease: Effects of Vitamin D and Omega-3 Fatty Acids

Abstract

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide and is characterized by excessive fat accumulation in the liver in individuals who do not consume alcohol. Hepatic fat accumulation is associated with elevated free fatty acids, increased hepatic de novo lipogenesis, and high dietary fat intake. NAFLD can progress from simple steatosis to non-alcoholic steatohepatitis (NASH) and, in advanced stages, to cirrhosis, liver failure, and hepatocellular carcinoma. Although the exact mechanisms underlying the pathogenesis of NAFLD remain unclear, insulin resistance, oxidative stress, and systemic inflammation are recognized as key factors contributing to its development and severity. This review aims to summarize the effects of vitamin D and omega-3 fatty acids on insulin resistance, oxidative stress, and systemic inflammation, which are major risk factors for NAFLD. In recent years, vitamin D and omega-3 fatty acids have attracted considerable attention due to their potential beneficial effects in the prevention and treatment of various diseases, including diabetes and cancer. However, the treatment of NAFLD remains controversial. Currently, weight loss through lifestyle modification is the only widely recommended therapeutic strategy, although novel treatment approaches are under investigation. While insulin sensitizers and lipid-lowering agents are used as part of medical management, growing evidence suggests that certain nutritional supplements, such as omega-3 fatty acids and vitamin D, may have preventive and therapeutic potential in NAFLD. Several studies have demonstrated that supplementation with omega-3 fatty acids and vitamin D can reduce inflammatory markers and contribute to improvements in hepatic steatosis. Through their anti-inflammatory and antioxidant properties, these bioactive compounds may represent promising adjunctive treatment options for NAFLD.

Keywords

• Vitamin D
• Inflammation
• Insulin resistance
• Non-alcoholic fatty liver disease
• Oxidative stress
• Omega-3 fatty acids

Kaynakça

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