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      Plasma levels of vitamin E and carotenoids are decreased in patients with nonalcoholic steatohepatitis (NASH)

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          Abstract

          Objectives

          Oxidative stress is suggested to play an important role in the pathogenesis of nonalcoholic steatohepatitis (NASH). The present study was aimed to compare plasma levels of antioxidants in patients suffering from NASH and healthy controls.

          Methods

          Plasma levels of the antioxidants α-tocopherol, γ-tocopherol, lutein, zeaxanthin, β-cryptoxanthin, lycopene, α-carotene β-carotene were determined in 57 patients with biopsy-proven NASH and 40 healthy controls.

          Results

          Levels of α-tocopherol (22.4 vs. 26.8 nmol/ ml; p < 0.01), lutein (0.19 vs. 0.33 nmol/ml; p < 0.0001), zeaxanthin (0.04 vs. 0.08 nmol/ml; p < 0.0001), lycopene (0.15 vs. 0.42 nmol/ml; p < 0.0001), α-carotene (0.03 vs. 0.06 nmol/ml; p < 0.005) and β-carotene (0.25 vs. 0.39 nmol/ml; p < 0.01) were significantly decreased in NASH patients compared to controls. Age, aminotransferase status (ALT, AST) and BMI were not correlated with the levels of tocopherols or carotenoids.

          Conclusions

          Given the decreased levels supplementation of lipophilic antioxidants might be a rational treatment option for patients with NASH.

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          Vitamin E treatment of nonalcoholic steatohepatitis in children: a pilot study.

          Kory Lavine (2000)
          To determine whether supplemental oral vitamin E is effective in lowering serum aminotransferase and alkaline phosphatase levels in children with nonalcoholic steatohepatitis (NASH) associated with obesity. Open-label pilot study enrolling all children <16 years old with chronically elevated serum aminotransferase (alanine aminotransferase and aspartate aminotransferase) levels for greater than 3 months, who demonstrated a diffusely echogenic liver on ultrasonography, had no demonstrable reason for abnormal serum chemistry values other than obesity, and therefore were diagnosed to have NASH. Patients were prescribed oral vitamin E between 400 and 1200 IU per day. Serum chemistry values were monitored monthly during treatment. Eleven subjects with a mean age of 12.4 years were enrolled; treated patients were followed up for 4 to 10 months. The body mass index did not change significantly before and after treatment (32.8 +/- 3.8 kg/m(2) vs 32.5 +/- 4.4 kg/m(2), respectively). Serum alanine aminotransferase decreased from 175 +/- 106 IU/L to 40 +/- 26 IU/L (P <.001, paired Student t test), serum aspartate aminotransferase decreased from 104 +/- 61 IU/L to 33 +/- 11 IU/L (P <.002), and alkaline phosphatase decreased from 279 +/- 42 IU/L to 202 +/- 66 IU/L (P <.003) during treatment. Serum aminotransferase levels remained normal during treatment but returned to abnormal in those electing to stop treatment. Serum alpha-tocopherol levels were within the normal range before the commencement of therapy and increased significantly with supplementation. The liver remained diffusely echogenic during therapy, at the time serum aminotransferase levels were reduced. Daily oral vitamin E administration normalized serum aminotransferase and alkaline phosphatase levels in children with NASH. Obese children with NASH should be encouraged to lose weight as part of a comprehensive weight reduction program and to consider taking supplemental alpha-tocopherol.
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            Plasma transforming growth factor-beta1 level and efficacy of alpha-tocopherol in patients with non-alcoholic steatohepatitis: a pilot study.

            K. Nakamura, I Makino, A Terano … (2001)
            Non-alcoholic steatohepatitis is a distinct entity, characterized by fatty change, lobular inflammation and fibrosis of the liver. Some cases of non-alcoholic steatohepatitis progress to cirrhosis, but it is not easy to distinguish this disease from non-alcoholic fatty liver by non-invasive examinations. No proven therapy for non-alcoholic steatohepatitis exists. Transforming growth factor-beta1 is implicated in the development of liver fibrosis, and is inhibited by alpha-tocopherol (vitamin E) in the liver. Therefore, in this study, the significance of the measurement of the level of plasma transforming growth factor-beta1 and the effect of alpha-tocopherol on the clinical course of non-alcoholic steatohepatitis were investigated. Twelve patients with non-alcoholic steatohepatitis and 10 patients with non-alcoholic fatty liver, with a diagnosis confirmed by liver biopsy, were studied. None of the patients had a history of alcohol abuse, habitual medicine or malignant or inflammatory diseases. All patients were negative for hepatitis B, C and G virus. Patients were given dietary instruction for 6 months, and then alpha-tocopherol (300 mg/day) was given for 1 year. Blood chemistries, measurement of plasma transforming growth factor-beta1 level and liver biopsies were undertaken before and after the 1-year alpha-tocopherol treatment. The serum alanine transaminase level decreased in non-alcoholic fatty liver patients, but not in non-alcoholic steatohepatitis patients, after 6 months of dietary therapy. Although the serum alanine transaminase level in non-alcoholic steatohepatitis patients was reduced during the 1-year alpha-tocopherol treatment, alpha-tocopherol had no effect on the serum alanine transaminase level in non-alcoholic fatty liver patients. The histological findings, such as steatosis, inflammation and fibrosis, of the non-alcoholic steatohepatitis patients were improved after alpha-tocopherol treatment. The plasma transforming growth factor-beta1 level in non-alcoholic steatohepatitis patients was significantly elevated compared with that in non-alcoholic fatty liver patients and healthy controls, and decreased, accompanied by an improvement in serum alanine transaminase level, with alpha-tocopherol treatment. Our data suggest that the measurement of the level of plasma transforming growth factor-beta1 represents a possible method of distinguishing between non-alcoholic steatohepatitis and non-alcoholic fatty liver. Long-term alpha-tocopherol treatment may be safe and effective for non-alcoholic steatohepatitis. A randomized, controlled, double-blind trial is needed to confirm the full potential of alpha-tocopherol in the management of non-alcoholic steatohepatitis.
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              Analysis of lipophilic antioxidants in human serum and tissues: tocopherols and carotenoids.

              Olivier Aust, Helmut Sies, Wilhelm Stahl … (2001)
              Tocopherols and carotenoids are naturally occurring lipophilic micronutrients, suggested to play a role in the prevention of several degenerative diseases. Thus, methods for the quantification of these nutrients in human samples have been developed during recent years. Blood and tissue levels of tocopherols and carotenoids are influenced by a variety of parameters related to disease, age, diet and lifestyle. This review summarizes general aspects of chromatographic analysis of tocopherols and carotenoids in human samples and deals with information on the outcome of human studies, in which such measurements were applied.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Eur J Med Res
                Journal ID (iso-abbrev): Eur. J. Med. Res
                Title: European Journal of Medical Research
                Publisher: BioMed Central
                ISSN (Print): 0949-2321
                ISSN (Electronic): 2047-783X
                Publication date Collection: 2011
                Publication date (Electronic): 24 February 2011
                Volume: 16
                Issue: 2
                Pages: 76-78
                Affiliations
                [1 ]Clinic of Gastroenterology, Hepatology and Infectious Diseases, Heinrich-Heine-Universität, Düsseldorf, Germany
                [2 ]Institute of Biochemistry and Molecular Biology I, Heinrich-Heine-Universität, Düsseldorf, Germany
                [3 ]Department of Medical and Surgical Sciences, Universita degli Studi di Padova, Padova, Italy
                [4 ]Institute of Pathology, Rheinisch-Westfälisch-Technische-Universität, Aachen, Germany
                Article
                Publisher ID: 2047-783X-16-2-76
                DOI: 10.1186/2047-783X-16-2-76
                PMC ID: 3353426
                PubMed ID: 21463986
                SO-VID: fcaca6ba-cd65-4655-b932-cd387e76df35
                Copyright © Copyright ©2011 I. Holzapfel Publishers
                History
                Date received : 20 December 2010
                Date accepted : 20 January 2011
                Categories
                Subject: Research

                ScienceOpen disciplines: Medicine
                Keywords: nash,antioxidants,vitamin e,vitamin a
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: nash, antioxidants, vitamin e, vitamin a

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