Evaluation of the effectiveness of vitamin E in nonalcoholic fatty liver disease among type 2 diabetes patients without advanced fibrosis

Authors

DOI:

https://doi.org/10.24265/horizmed.2023.v23n1.02

Keywords:

fibrosis, vitamin E, diabetes mellitus, type 2, fatty liver

Abstract

Objective: To determine the effectiveness of vitamin E in nonalcoholic fatty liver disease (NAFLD) among type 2 diabetes patients without advanced fibrosis.
Materials and methods: A quasi-experimental analytical study consisting of two groups: an experimental one, which received vitamin E 400 IU in addition to the standard treatment, and a control group, which received only the standard treatment. The study included 71 patients in each group. Both groups underwent liver fibrosis scoring, liver ultrasound and glutamate pyruvate transaminase measurement at study baseline and after six months. Moreover, the Wilcoxon test was used to compare the concentrations of fibrosis score and glutamate pyruvate transaminase values within the same group, and the Mann-Whitney U test was used to evaluate the differences between the experimental and control groups. The Wilcoxon test was also used to compare ultrasound severity. Then, a logistic regression analysis was performed. The information was entered into a data collection sheet using Microsoft Excel; afterwards, a database was coded and created using IBM SPSS Statistics statistical software 23.0. Results: Among the results, it was found that vitamin E was significantly effective in reducing liver fibrosis, transaminase and ultrasound severity scores (Z = -4.727 and p < 0.05). According to the logistic regression analysis, glutamate pyruvate transaminase levels and fibrosis score are not substantially explained by the confounding variables included in the model at 95 % confidence. Conclusions: Vitamin E at a dose of 400 IU given orally for six months is an effective intervention to control the progression
of liver disease, which can be quantified by fibrosis score, transaminase reduction and ultrasound assessment after a 6-month follow-up.

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References

Abner EL, Schmitt FA, Mendiondo MS, Marcum JL, Kryscio RJ. Vitamin E and all-cause mortality: a meta-analysis. Curr Aging Sci. 2011; 4(2): 158-70.

Angulo P. Nonalcoholic fatty liver disease. N Engl J Med. 2002; 346(16): 1221-31.

Arun J. Sanyal. "Estudio sobre uso de vitamina E y pioglitazona vs. placebo en esteatohepatitis no alcohólica." N Engl J Med., 2010: 1684.

Dyson J, Day C. Treatment of non-alcoholic fatty liver disease. Dig Dis. 2014; 32: 597-604.

Del Ben M, Polimeni L, Baratta F, Pastori D, Loffredo L, Angelico F. Modern approach to the clinical management of non-alcoholic fatty liver disease. World J Gastroenterol. 2014; 20(26): 8341-50.

Hannah WN Jr, Harrison SA. Lifestyle and Dietary Interventions in the Management of Nonalcoholic Fatty Liver Disease. Dig Dis Sci. 2016; 61(5): 1365-74.

Hong-Fang Ji, Sun Y, Shen L. Effect of vitamin E supplementation on aminotransferase levels in patients with NAFLD, NASH and CHC: results from a meta-analysis. Nutrition. 2014; 30(9): 986-91.

Ji HF, Shen L. On the mechanism of action of vitamin E for nonalcoholic steatohepatitis. Hepatology. 2011; 53(3): 1067.

Ji HF, Sun Y, Shen L. Efecto de la suplementación de vitamina E en los niveles de transaminasas en pacientes con hígado graso no alcohólico, NASH, y CHC: Los resultados de un metaanálisis. Nutrition, 2014: 991.

Milic S, Mikolasevic I, Krznaric-Zmic I, Stanic M, Poropat G, Stimac D, et al. Nonalcoholic steatohepatitis: emerging targeted therapies to optimize treatment options. Drug Des Devel Ther. 2015; 9: 4835-45.

Manrique GM. Parámetros metabólicos en pacientes con esteatosis hepática no alcohólica y diabetes tipo 2 controlados versus no controlados. Rev Gastroenterol Perú. 2016; 36(4): 336-9.

Sanyal AJ, Mofrad PS, Contos MJ, Sargeant C, Luketic VA, Sterling RK, et al. A pilot study of vitamin E versus vitamin E and pioglitazone for the treatment of nonalcoholic steatohepatitis. Clin Gastroenterol Hepatol. 2004; 2(12): 1107-15.

Sumida Y, Naito Y, Tanka S, Saki K, Inada Y, Taketani H, et al. Long- term (C 2 year) efficacy of vitamin E for non-alcoholic steatohepatitis. Hepatogastroenterology. 2013; 60: 1445-50.

Vajro P, Mandato C, Franzese A, Ciccimarra E, Lucariello S, Savoia M, et al. Vitamin E treatment in pediatric obesity-related liver disease: a randomized study. J Pediatr Gastroenterol Nutr. 2004; 38(1): 48-55.

Lavine JE, Schwimmer JB, Natta MLV, Molleston JP, Murray KF, Rosenthal P, et al. Effect of vitamin E or metformin for treatment of nonalcoholic fatty liver disease in children and adolescents: the TONIC randomized controlled trial. JAMA. 2011; 305(16): 1659-68.

Yakaryilmaz F, Guliter S, Savas B, Erdem O, Ersoy R, Erden E, et al. Effects of vitamin E treatment on peroxisome proliferator-activated receptor-alpha expression and insulin resistance in patients with non-alcoholic steatohepatitis: Results of a pilot study. Inter Med J. 2007; 37: 229-35.

Rinella ME. Nonalcoholic fatty liver disease: a systematic review. JAMA. 2015; 313(22): 2263-73.

Amanullah I, Khan YH, Anwar I, Gulzar A, Mallhi TH, Raja AA. Effect of vitamin E in non-alcoholic fatty liver disease: a systematic review and meta-analysis of randomised controlled trials. Postgrad Med J. 2019; 95(1129): 601-11.

Sumida Y, Yoneda M, Seko Y, Takahashi H, Hara N, Fujii H, et al. Role of vitamin E in the treatment of non-alcoholic steatohepatitis. Free Radic Biol Med. 2021; 177: 391-403.

Oseini AM, Sanyal AJ. Therapies in non-alcoholic steatohepatitis (NASH). Liver Int. 2017; 37(Suppl. 1):97-103.

Banini BA, Sanyal AJ. Current and future pharmacologic treatment of nonalcoholic steatohepatitis. Curr Opin Gastroenterol. 2017; 33(3): 134-41.

Issa D, Patel V, Sanyal AJ. Future therapy for non-alcoholic fatty liver disease. Liver Int. 2018; 38(Suppl. 1): 56-63.

Perumpail BJ, Li AA, John N, Sallam S, Shah ND, Kwong W, et al. The Role of vitamin E in the treatment of NAFLD. Diseases. 2018; 6(4): 86.

Pacana T, Sanyal AJ. Vitamin E and nonalcoholic fatty liver disease. Curr Opin Clin Nutr Metab Care. 2012; 15(6): 641-8.

Nagashimada M, Ota T. Role of vitamin E in nonalcoholic fatty liver disease. IUBMB Life. 2019; 71(4): 516-22.

Petroni ML, Brodosi L, Bugianesi E, Marchesini G. Management of non-alcoholic fatty liver disease. BMJ. 2021; 372: m4747.

Athyros VG, Polyzos SA, Kountouras J, Katsiki N, Anagnostis P,Doumas M, et al. Non-Alcoholic Fatty Liver Disease Treatment in Patients with Type 2 Diabetes Mellitus; New Kids on the Block. Curr Vasc Pharmacol. 2020; 18(2): 172-81.

Blazina I, Selph S. Diabetes drugs for nonalcoholic fatty liver disease: a systematic review. Syst Rev. 2019; 8(1): 295.

Caldwell S. NASH Therapy: omega 3 supplementation, vitamin E, insulin sensitizers and statin drugs. Clin Mol Hepatol. 2017; 23(2): 103-8.

Takahashi Y, Sugimoto K, Inui H, Fukusato T. Current pharmacological therapies for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis. World J Gastroenterol. 2015; 21(13): 3777-85.

Published

2023-03-03

How to Cite

1.
Miranda Manrique G. Evaluation of the effectiveness of vitamin E in nonalcoholic fatty liver disease among type 2 diabetes patients without advanced fibrosis. Horiz Med [Internet]. 2023Mar.3 [cited 2025May1];23(1):e1961. Available from: https://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/1961

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