human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Because dietary N-3 fatty acids reduce plasma triglycerides , they may also decrease hepatic triglyceride content . If so , N-3 fatty acids might constitute a therapy for fatty liver . Methods Twenty-two subjects were recruited into a study design ed to test the effects of N-3 fatty acids on liver fat content . Seventeen completed the trial that had a sequential design of 4-week placebo followed by an 8-week treatment with 9 g/d of fish oil .  Liver fat was measured during placebo and treatment by magnetic resonance spectroscopy .  Compliance was assessed by capsule count at the end of each study phase and measurement of fatty acid composition in plasma triglyceride and phospholipid . Plasma lipoproteins and adiponectin were also measured . Results Treatment with fish oils reduced significantly levels of plasma triglyceride by 46 % ( P < .03 ) , very low-density lipoprotein + intermediate density lipoprotein cholesterol by 21 % ( P < .03 ) , total apolipoprotein B by 15 % ( P < .03 ) . In contrast to the changes in plasma triglycerides , hepatic triglyceride content was not significantly reduced by fish oil treatment . Conclusions N-3 fatty acids at high doses lower plasma triglyceride levels , but there are no significant decreases in hepatic content of triglyceride for the group as a whole . Whereas the triglyceride lowering is uniform , the liver response is more variable The aim of this study was to determine if orlistat , an inhibitor of fat absorption , combined with caloric restriction in overweight subjects with nonalcoholic steatohepatitis results in weight loss and improved liver histology .  Fifty overweight subjects ( body mass index = > or=27 ) with biopsy proven nonalcoholic steatohepatitis were r and omized to receive a 1,400 Kcal/day diet plus vitamin E ( 800 IU ) daily with or without orlistat ( 120 mg three times a day ) for 36 weeks . Liver biopsies were repeated at week 36 . Twenty-three subjects in the orlistat/diet/vitamin E group and 18 in the diet/vitamin E group completed the study . The mean age was 47 + /- 9.0 ( st and ard deviation ) years and mean body mass index was 36.4 + /- 6.3 kg/m(2 ) . Four subjects were diabetic . The orlistat group lost a mean of 8.3 % body weight compared to 6.0 % in the diet plus vitamin E group ( not significant ) . Both groups also had similarly improved serum aminotransferases , hepatic steatosis , necroinflammation , ballooning , and nonalcoholic fatty liver disease activity scores . Stratified according to weight loss instead of treatment group , a loss of > or=5 % body weight ( n = 24 ) compared to < 5 % body weight ( n = 17 ) correlated with improvement in insulin sensitivity ( P = 0.001 ) and steatosis ( P = 0.015 ) . Comparing subjects who lost > or=9 % of body weight ( n = 16 ) , to those that did not ( n = 25 ) , improved insulin sensitivity ( P < 0.001 ) , adiponectin ( P = 0.03 ) , steatosis ( P = 0.005 ) , ballooning ( P = 0.04 ) , inflammation ( P = 0.045 ) , and nonalcoholic fatty liver disease activity score ( P = 0.009 ) were seen . Increases in adiponectin strongly correlated with improved ballooning and nonalcoholic fatty liver disease activity score ( P = 0.03 ) . Orlistat did not enhance weight loss or improve liver enzymes , measures of insulin resistance , and histopathology . However , subjects who lost > or=5 % of body weight over 9 months improved insulin resistance and steatosis , and those subjects who lost > or=9 % also achieved improved hepatic histologic changes BACKGROUND Long-chain polyunsaturated fatty acid omega-3 levels are decreased in the hepatic tissue of patients with nonalcoholic fatty liver disease .  Polyunsaturated fatty acids are negative regulators of hepatic lipogenesis and attenuate the inflammatory response in mice . AIM To investigate whether polyunsaturated fatty acid may be effective in the treatment of nonalcoholic fatty liver disease . METHODS Forty patients with nonalcoholic fatty liver disease were r and omized into two groups for treatment of 6 months duration . Group DP ( n=20 ) received an AHA recommended diet and polyunsaturated fatty acid 2g/day ; Group D ( n=20 ) received only the AHA regular diet . Outcome measurements were fatty liver assessed by abdominal ultrasound , liver aminotransferase and tumour necrosis factor-alpha serum levels , and insulin resistance assessed by HOMA(IR ) . RESULTS After 6 months of treatment , the DP group displayed a decrease in alanine aminotransferase levels ( p<0.01 ) , as well as in triglyceride levels ( p<0.01 ) , serum tumour necrosis factor-alpha levels ( p<0.05 ) and in HOMA(IR ) ( p<0.05 ) . In the D group , no significant modification was observed . In the DP group , complete fatty liver regression was observed in 33.4 % of the patients , and an overall reduction in 50 % . In contrast , no patient achieved complete regression in the D group , whereas some amount of reduction occurred in 27.7 % of the patients ; the remaining 72.2 % did not change . CONCLUSION Our results indicate that alanine aminotransferase , triglyceride and serum tumour necrosis factor-alpha levels , as well as fatty liver improved after polyunsaturated fatty acid administration BACKGROUND Blood lipids and inflammatory markers levels have been associated with the development and progression of atherosclerosis . As the association of inflammatory markers with plasma fatty acids has not been extensively evaluated and understood , we sought to investigate the associations between dietary and plasma fatty acids with various inflammation and coagulation markers . METHODS High sensitivity C-reactive protein ( hsCRP ) , interleukin-6 ( IL-6 ) , tumor necrosis factor-alpha ( TNF-alpha ) , fibrinogen , and homocysteine were measured in serum of 374 free-living , healthy men and women , r and omly selected from the ATTICA 's study data base .  Total plasma fatty acids  were determined by gas chromatography . Dietary fatty acids  were assessed through a semi-quantitative FFQ . RESULTS Multi-adjusted regression analyses revealed that plasma n-3 fatty acids were inversely associated with CRP , IL-6 and TNF-alpha ; plasma n-6 fatty acids were inversely associated with CRP , IL-6 and fibrinogen ; monounsaturated fatty acids were inversely associated with CRP and IL-6 ( all p-values<0.05 ) . Interestingly , the n-6/n-3 ratios exhibited the strongest positive correlations with all the markers studied . No associations were observed between dietary fatty acids and the investigated markers . CONCLUSIONS Measurements of total plasma fatty acids could provide insights into the relationships between diet and atherosclerotic disease . Moreover , the n-6/n-3 ratio may constitute a predictor of low- grade inflammation and coagulation OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity BACKGROUND Dyslipidemia , which has been closely linked to pathophysiology of cardiovascular diseases , is a key independent modifiable risk factor for cardiovascular diseases . Estimation of the prevalence of dyslipidemia ensures proper planning of health actions for both primary and secondary prevention of cardiovascular diseases . OBJECTIVES To estimate the prevalence of various types of dyslipidemia and determine their associated factors among adults in north of Jordan . METHOD Data were analyzed from a cross-sectional study that included a r and om sample of 1121 Jordanians aged 25 years and older .  High total cholesterol ( TC ) was defined as TC ≥200 mg/dL and hypertriglyceridemia as serum triglycerides level ≥150 mg/dL. Low high-density lipoprotein cholesterol ( HDL-C ) was defined as serum HDL-C < 40 mg/dL. High low-density lipoprotein cholesterol ( LDL-C ) was defined as serum LDL-C ≥130 mg/dL. RESULTS Of a total of 1121 subjects , 48.8 % had high TC level , 40.7 % had high LDL-C  , 40.1 % had low HDL-C , 43.6 % had high triglyceride levels , and 75.7 % had at least one abnormal lipid level . Age was associated with high triglycerides , high LDL-C , and high TC . Men were more likely than women to have a high triglycerides level and low HDL-C. Compared with people with a body mass index < 25 , overweight and obese subjects had greater odds of having high triglycerides , high TC , and low HDL-C. Diabetes was associated with increased odds of high triglycerides only . CONCLUSION The prevalence dyslipidemia is high in Jordan , which necessitates appropriate the institution of community-based intervention strategies to prevent and manage cardiovascular risk factors AIM To investigate the efficacy and safety of n-3 polyunsaturated fatty acids ( PUFA ) from seal oils for patients with nonalcoholic fatty liver disease ( NAFLD ) associated with hyperlipidemia . METHODS One hundred and forty-four patients with NAFLD associated with hyperlipidemia were included in the 24-wk , r and omized , controlled trial . The patients were r and omized into two groups . Group A ( n=72 ) received recommended diet and 2 g n-3 PUFA from seal oils , three times a day . Group B ( n=72 ) received recommended diet and 2 g placebo , three times a day . Primary endpoints were fatty liver assessed by symptom scores , liver alanine aminotransferase ( ALT ) and serum lipid levels after 8 , 12 , 16 , and 24 wk . Hepatic fat infiltration was detected by ultrasonography at weeks 12 and 24 after treatment . RESULTS A total of 134 patients ( 66 in group A , 68 in group B ) were included in the study except for 10 patients who were excluded from the study . After 24 wk of treatment , no change was observed in body weight , fasting blood glucose ( FBG ) , renal function and blood cells of these patients . Total symptom scores , ALT and triglyceride ( TG ) levels decreased more significantly in group A than in group B ( P<0.05 ) . As expected , there was a tendency toward improvement in aspartate aminotransferase ( AST ) , gamma-glutamyltranspeptidase ( GGT ) , and total cholesterol ( TCHO ) and high-density lipoprotein ( HDL ) cholesterol levels ( P<0.05 ) after administration in the two groups . However , no significant differences were found between the two groups . The values of low-density lipoprotein ( LDL ) were significantly improved in group A ( P<0.05 ) , 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Because dietary N-3 fatty acids reduce plasma triglycerides , they may also decrease hepatic triglyceride content . If so , N-3 fatty acids might constitute a therapy for fatty liver . Methods Twenty-two subjects were recruited into a study design ed to test the effects of N-3 fatty acids on liver fat content . Seventeen completed the trial that had a sequential design of 4-week placebo followed by an 8-week treatment with 9 g/d of fish oil .  Liver fat was measured during placebo and treatment by magnetic resonance spectroscopy .  Compliance was assessed by capsule count at the end of each study phase and measurement of fatty acid composition in plasma triglyceride and phospholipid . Plasma lipoproteins and adiponectin were also measured . Results Treatment with fish oils reduced significantly levels of plasma triglyceride by 46 % ( P < .03 ) , very low-density lipoprotein + intermediate density lipoprotein cholesterol by 21 % ( P < .03 ) , total apolipoprotein B by 15 % ( P < .03 ) . In contrast to the changes in plasma triglycerides , hepatic triglyceride content was not significantly reduced by fish oil treatment . Conclusions N-3 fatty acids at high doses lower plasma triglyceride levels , but there are no significant decreases in hepatic content of triglyceride for the group as a whole . Whereas the triglyceride lowering is uniform , the liver response is more variable The aim of this study was to determine if orlistat , an inhibitor of fat absorption , combined with caloric restriction in overweight subjects with nonalcoholic steatohepatitis results in weight loss and improved liver histology .  Fifty overweight subjects ( body mass index = > or=27 ) with biopsy proven nonalcoholic steatohepatitis were r and omized to receive a 1,400 Kcal/day diet plus vitamin E ( 800 IU ) daily with or without orlistat ( 120 mg three times a day ) for 36 weeks . Liver biopsies were repeated at week 36 . Twenty-three subjects in the orlistat/diet/vitamin E group and 18 in the diet/vitamin E group completed the study . The mean age was 47 + /- 9.0 ( st and ard deviation ) years and mean body mass index was 36.4 + /- 6.3 kg/m(2 ) . Four subjects were diabetic . The orlistat group lost a mean of 8.3 % body weight compared to 6.0 % in the diet plus vitamin E group ( not significant ) . Both groups also had similarly improved serum aminotransferases , hepatic steatosis , necroinflammation , ballooning , and nonalcoholic fatty liver disease activity scores . Stratified according to weight loss instead of treatment group , a loss of > or=5 % body weight ( n = 24 ) compared to < 5 % body weight ( n = 17 ) correlated with improvement in insulin sensitivity ( P = 0.001 ) and steatosis ( P = 0.015 ) . Comparing subjects who lost > or=9 % of body weight ( n = 16 ) , to those that did not ( n = 25 ) , improved insulin sensitivity ( P < 0.001 ) , adiponectin ( P = 0.03 ) , steatosis ( P = 0.005 ) , ballooning ( P = 0.04 ) , inflammation ( P = 0.045 ) , and nonalcoholic fatty liver disease activity score ( P = 0.009 ) were seen . Increases in adiponectin strongly correlated with improved ballooning and nonalcoholic fatty liver disease activity score ( P = 0.03 ) . Orlistat did not enhance weight loss or improve liver enzymes , measures of insulin resistance , and histopathology . However , subjects who lost > or=5 % of body weight over 9 months improved insulin resistance and steatosis , and those subjects who lost > or=9 % also achieved improved hepatic histologic changes BACKGROUND Long-chain polyunsaturated fatty acid omega-3 levels are decreased in the hepatic tissue of patients with nonalcoholic fatty liver disease .  Polyunsaturated fatty acids are negative regulators of hepatic lipogenesis and attenuate the inflammatory response in mice . AIM To investigate whether polyunsaturated fatty acid may be effective in the treatment of nonalcoholic fatty liver disease . METHODS Forty patients with nonalcoholic fatty liver disease were r and omized into two groups for treatment of 6 months duration . Group DP ( n=20 ) received an AHA recommended diet and polyunsaturated fatty acid 2g/day ; Group D ( n=20 ) received only the AHA regular diet . Outcome measurements were fatty liver assessed by abdominal ultrasound , liver aminotransferase and tumour necrosis factor-alpha serum levels , and insulin resistance assessed by HOMA(IR ) . RESULTS After 6 months of treatment , the DP group displayed a decrease in alanine aminotransferase levels ( p<0.01 ) , as well as in triglyceride levels ( p<0.01 ) , serum tumour necrosis factor-alpha levels ( p<0.05 ) and in HOMA(IR ) ( p<0.05 ) . In the D group , no significant modification was observed . In the DP group , complete fatty liver regression was observed in 33.4 % of the patients , and an overall reduction in 50 % . In contrast , no patient achieved complete regression in the D group , whereas some amount of reduction occurred in 27.7 % of the patients ; the remaining 72.2 % did not change . CONCLUSION Our results indicate that alanine aminotransferase , triglyceride and serum tumour necrosis factor-alpha levels , as well as fatty liver improved after polyunsaturated fatty acid administration BACKGROUND Blood lipids and inflammatory markers levels have been associated with the development and progression of atherosclerosis . As the association of inflammatory markers with plasma fatty acids has not been extensively evaluated and understood , we sought to investigate the associations between dietary and plasma fatty acids with various inflammation and coagulation markers . METHODS High sensitivity C-reactive protein ( hsCRP ) , interleukin-6 ( IL-6 ) , tumor necrosis factor-alpha ( TNF-alpha ) , fibrinogen , and homocysteine were measured in serum of 374 free-living , healthy men and women , r and omly selected from the ATTICA 's study data base .  Total plasma fatty acids  were determined by gas chromatography . Dietary fatty acids  were assessed through a semi-quantitative FFQ . RESULTS Multi-adjusted regression analyses revealed that plasma n-3 fatty acids were inversely associated with CRP , IL-6 and TNF-alpha ; plasma n-6 fatty acids were inversely associated with CRP , IL-6 and fibrinogen ; monounsaturated fatty acids were inversely associated with CRP and IL-6 ( all p-values<0.05 ) . Interestingly , the n-6/n-3 ratios exhibited the strongest positive correlations with all the markers studied . No associations were observed between dietary fatty acids and the investigated markers . CONCLUSIONS Measurements of total plasma fatty acids could provide insights into the relationships between diet and atherosclerotic disease . Moreover , the n-6/n-3 ratio may constitute a predictor of low- grade inflammation and coagulation OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity BACKGROUND Dyslipidemia , which has been closely linked to pathophysiology of cardiovascular diseases , is a key independent modifiable risk factor for cardiovascular diseases . Estimation of the prevalence of dyslipidemia ensures proper planning of health actions for both primary and secondary prevention of cardiovascular diseases . OBJECTIVES To estimate the prevalence of various types of dyslipidemia and determine their associated factors among adults in north of Jordan . METHOD Data were analyzed from a cross-sectional study that included a r and om sample of 1121 Jordanians aged 25 years and older .  High total cholesterol ( TC ) was defined as TC ≥200 mg/dL and hypertriglyceridemia as serum triglycerides level ≥150 mg/dL. Low high-density lipoprotein cholesterol ( HDL-C ) was defined as serum HDL-C < 40 mg/dL. High low-density lipoprotein cholesterol ( LDL-C ) was defined as serum LDL-C ≥130 mg/dL. RESULTS Of a total of 1121 subjects , 48.8 % had high TC level , 40.7 % had high LDL-C  , 40.1 % had low HDL-C , 43.6 % had high triglyceride levels , and 75.7 % had at least one abnormal lipid level . Age was associated with high triglycerides , high LDL-C , and high TC . Men were more likely than women to have a high triglycerides level and low HDL-C. Compared with people with a body mass index < 25 , overweight and obese subjects had greater odds of having high triglycerides , high TC , and low HDL-C. Diabetes was associated with increased odds of high triglycerides only . CONCLUSION The prevalence dyslipidemia is high in Jordan , which necessitates appropriate the institution of community-based intervention strategies to prevent and manage cardiovascular risk factors AIM To investigate the efficacy and safety of n-3 polyunsaturated fatty acids ( PUFA ) from seal oils for patients with nonalcoholic fatty liver disease ( NAFLD ) associated with hyperlipidemia . METHODS One hundred and forty-four patients with NAFLD associated with hyperlipidemia were included in the 24-wk , r and omized , controlled trial . The patients were r and omized into two groups . Group A ( n=72 ) received recommended diet and 2 g n-3 PUFA from seal oils , three times a day . Group B ( n=72 ) received recommended diet and 2 g placebo , three times a day . Primary endpoints were fatty liver assessed by symptom scores , liver alanine aminotransferase ( ALT ) and serum lipid levels after 8 , 12 , 16 , and 24 wk . Hepatic fat infiltration was detected by ultrasonography at weeks 12 and 24 after treatment . RESULTS A total of 134 patients ( 66 in group A , 68 in group B ) were included in the study except for 10 patients who were excluded from the study . After 24 wk of treatment , no change was observed in body weight , fasting blood glucose ( FBG ) , renal function and blood cells of these patients . Total symptom scores , ALT and triglyceride ( TG ) levels decreased more significantly in group A than in group B ( P<0.05 ) . As expected , there was a tendency toward improvement in aspartate aminotransferase ( AST ) , gamma-glutamyltranspeptidase ( GGT ) , and total cholesterol ( TCHO ) and high-density lipoprotein ( HDL ) cholesterol levels ( P<0.05 ) after administration in the two groups . However , no significant differences were found between the two groups . The values of low-density lipoprotein ( LDL ) were significantly improved in group A ( P<0.05 ) , 
    Output:
    