Gorduras trans e interesterificadas no desenvolvimento da doença hepática gordurosa não-alcoólica em ensaios pré-clínicos com roedores: uma revisão sistemática

Abstract

Non-alcoholic fatty liver disease (NAFLD) is characterized by the excessive fat accumulation in the liver, which may compromise the function of this organ and progress to cirrhosis and hepatocellular carcinoma. This condition affects around 25% of the adult population and its increasing prevalence constitutes a major threat to public health. Evidence reinforces the idea that diet indeed plays a central role in NAFLD pathogenesis. Not only the amount of intake, but also the type of dietary fat - including chemically modified lipids, such as interesterified and trans fats - may influence the disease development. Rodent models have been widely used to understand the NAFLD pathogenesis and mimic the human disease in preclinical assays. However, the heterogeneity of diets, the little attention directed at the source of the dietary components and a lack of standardization of control groups may compromise the accuracy and interpretation of the studies’ findings, even questioning the theory that chemically modified lipids’ consumption is linked to deleterious effects. Thus, we systematically assessed the preclinical literature examining the composition of diets used in assays with chemically modified lipids and rodent models of NAFLD, and the effects of those dietary interventions. The search was conducted on the MEDLINE electronic database in December 2020. Only articles published in English after 1993 were included. Data was extracted from graphs and tables of included studies with the use of a digitizing software. In total, 2132 studies were retrieved. 1042 studies were excluded in the first screening phase, and 1086 in the second. A total of 6 studies were included in the analysis. The lack of interventions enriched in fat or with chemically modified fats, the use of transgenic models, in vitro studies, chemical/pharmacological induction of NAFLD and insufficient information about the diet were frequent exclusion criteria. The most pronounced differences were in relation to diet composition and the period of intervention. Although there are several studies on the effects of high-fat diets on steatosis, there is a gap in the knowledge of how the inclusion of chemically modified fats may influence the development of NAFLD, due to several confusion variables. The findings of pre-clinical studies are insufficient, and the heterogeneity of the experiments prevent the summarization of evidence and may reduce the data’s validity in assessing the effects of chemically modified fat intake in the onset and progression of NAFLD.