Vitamin E Therapy in Non-Alcoholic Fatty Liver Disease

Abstract


Non-alcoholic fatty liver disease (NAFLD) is closely related to oxidative stress. Vitamin E (VE) is an effective antioxidant, which could relieve NAFLD symptoms by improving the balance of oxidation and anti-oxidation. However, recent researches indicate that the functional mechanisms of VE are not only limited to anti-oxidation, but also include adjusting the metabolism disorders of glucose and lipid. Furthermore, the efficacy of VE remains controversial in the treatment of NAFLD by far, and the suitable condition of patient, drug dosage, drug safety and course of treatment during clinical application still need to be discussed. Therefore, this paper reviewed the recent study progresses of clinical application of VE alone and VE and other drugs.


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X. Shu, L. Zhang and G. Ji, "Vitamin E Therapy in Non-Alcoholic Fatty Liver Disease," International Journal of Clinical Medicine, Vol. 5 No. 3, 2014, pp. 87-92. doi: 10.4236/ijcm.2014.53016.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] J. E. Lavine, J. B. Schwimmer, M. L. Van Natta, J. P. Molleston, K. F. Murray and P. Rosenthal, “Effect of Vitamin E or Metformin for Treatment of Nonalcoholic Fatty Liver Disease in Children and Adolescents: The TONIC Randomized Controlled Trial,” JAMA, Vol. 305, No. 16, 2011, pp. 1659-1668.
http://dx.doi.org/10.1001/jama.2011.520
[2] C. A. Matteoni, Z. M. Younossi, T. Gramlich, N. Boparai, Y. C. Liu and A. J. McCullough, “Nonalcoholic Fatty Liver Disease: A Spectrum of Clinical and Pathological severity,” Gastroenterology, Vol. 116, No. 6, 1999, pp. 1413-1419. http://dx.doi.org/10.1016/S0016-5085(99)70506-8
[3] T. Pacana and A. J. Sanyal, “Vitamin E and Nonalcoholic fatty Liver Disease,” Current Opinion in Clinical Nutrition & Metabolic Care, Vol. 15, No. 6, 2012, pp. 641-648.
http://dx.doi.org/10.1097/MCO.0b013e328357f747
[4] C. P. Day, “Pathogenesis of Steatohepatitis,” Best Practice & Research Clinical Gastroenterology, Vol. 16, No. 5, 2002, pp. 663-678.
http://dx.doi.org/10.1053/bega.2002.0333
[5] M. G. Traber and J. F. Stevens, “Vitamins C and E: Beneficial Effects from a Mechanistic Perspective,” Free Radical Biology & Medicine, Vol. 51, No. 5, 2011, pp. 1000-1013. http://dx.doi.org/10.1016/j.freeradbiomed.2011.05.017
[6] C. Y. Chang, C. K. Argo, A. M. Al-Osaimi and S. H. Caldwell, “Therapy of NAFLD: Antioxidants and Cytoprotective Agents,” Journal of Clinical Gastroenterology, Vol. 40, Suppl. 1, 2006, pp. S51-S60.
[7] G. Nowak, D. Bakajsova, C. Hayes, M. Hauer-Jensen and C. M. Compadre, “Gamma-Tocotrienol Protects against Mitochondrial Dysfunction and Renal Cell Death,” Journal of Pharmacology and Experimental Therapeutics, Vol. 340, No. 2, 2012, pp. 330-338.
http://dx.doi.org/10.1124/jpet.111.186882
[8] G. R. Buettner, “The Pecking Order of Free Radicals and Antioxidants: Lipid Peroxidation, Alpha-Tocopherol, and Ascorbate,” Archives of Biochemistry and Biophysics, Vol. 300, No. 2, 1993, pp. 535-543.
http://dx.doi.org/10.1006/abbi.1993.1074
[9] M. Kawanaka, S. Mahmood, G. Niiyama, A. Izumi, A. Kamei and H. Ikeda, “Control of Oxidative Stress and Reduction in Biochemical Markers by Vitamin E Treatment in Patients with Nonalcoholic Steatohepatitis: A Pilot Study,” Hepatology Research, Vol. 29, No. 1, 2004, pp. 39-41. http://dx.doi.org/10.1016/j.hepres.2004.02.002
[10] A. Kuhad and K. Chopra, “Attenuation of Diabetic Nephropathy by Tocotrienol: Involvement of NFkB Signaling Pathway,” Life Sciences, Vol. 84, No. 9-10, 2009, pp. 296-301. http://dx.doi.org/10.1016/j.lfs.2008.12.014
[11] J. E. Lavine, “Vitamin E Treatment of Nonalcoholic Steatohepatitis in Children: A Pilot Study,” The Journal of Pediatrics, Vol. 136, No. 6, 2000, pp. 734-738.
[12] E. Bugianesi, E. Gentilcore, R. Manini, S. Natale, E. Vanni and N. Villanova, “A Randomized Controlled Trial of Metformin Versus Vitamin E or Prescriptive Diet in Nonalcoholic Fatty Liver Disease,” The American Journal of Gastroenterology, Vol. 100, No. 5, 2005, pp. 1082-1090. http://dx.doi.org/10.1111/j.1572-0241.2005.41583.x
[13] T. Hasegawa, M. Yoneda, K. Nakamura, I. Makino and A. Terano, “Plasma Transforming Growth Factor-Beta1 Level and Efficacy of Alpha-Tocopherol in Patients with Non-Alcoholic Steatohepatitis: A Pilot Study,” Alimentary Pharmacology & Therapeutics, Vol. 15, No. 10, 2001, pp. 1667-1672.
http://dx.doi.org/10.1046/j.1365-2036.2001.01083.x
[14] F. Yakaryilmaz, S. Guliter, B. Savas, O. Erdem, R. Ersoy and E. Erden, “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,” Internal Medicine Journal, Vol. 37, No. 4, 2007, pp. 229-235.
http://dx.doi.org/10.1111/j.1445-5994.2006.01295.x
[15] A. J. Sanyal, N. Chalasani, K. V. Kowdley, A. McCullough, A. M. Diehl and N. M. Bass, “Pioglitazone, Vitamin E, or Placebo for Nonalcoholic Steatohepatitis,” The New England Journal of Medicine, Vol. 362, No. 18, 2010, pp. 1675-1685.
http://dx.doi.org/10.1056/NEJMoa0907929
[16] G. Paolisso, G. Di Maro, D. Galzerano, F. Cacciapuoti, G. Varricchio and M. Varricchio, “Pharmacological Doses of Vitamin E and Insulin Action in Elderly Subjects,” The American Journal of Clinical Nutrition, Vol. 59, No. 6, 1994, pp. 1291-1296.
[17] T. Costacou, B. Ma, I. B. King and E. J. Mayer-Davis, “Plasma and Dietary Vitamin E in Relation to Insulin Secretion and Sensitivity,” Diabetes, Obesity and Metabolism, Vol. 10, No. 3, 2008, pp. 223-228.
http://dx.doi.org/10.1111/j.1463-1326.2006.00683.x
[18] X. H. Shen, Q. Y. Tang, J. Huang and W. Cai, “Vitamin E Regulates Adipocytokine Expression in a Rat Model of Dietary-Induced Obesity,” Experimental Biology and Medicine (Maywood), Vol. 235, No. 1, 2010, pp. 47-51.
http://dx.doi.org/10.1258/ebm.2009.009122
[19] I. P. Tzanetakou, I. P. Doulamis, L. M. Korou, G. Agrogiannis, I. S. Vlachos and A. Pantopoulou, “Water Soluble Vitamin E Administration in Wistar Rats with Nonalcoholic Fatty Liver Disease,” The Open Cardiovascular Medicine Journal, Vol. 6, 2012, pp. 88-97.
http://dx.doi.org/10.2174/1874192401206010088
[20] A. J. Sanyal, P. S. Mofrad, M. J. Contos, C. Sargeant, V. A. Luketic and R. K. Sterling, “A Pilot Study of Vitamin E Versus Vitamin E and Pioglitazone for the Treatment of Nonalcoholic Steatohepatitis,” Clinical Gastroenterology and Hepatology, Vol. 2, No. 12, 2004, pp. 1107-1115.
http://dx.doi.org/10.1016/S1542-3565(04)00457-4
[21] K. J. Stewart, A. C. Bacher, K. Turner, J. G. Lim, P. S. Hees andE. P. Shapiro, “Exercise and Risk Factors Associated with Metabolic Syndrome in Older Adults,” American Journal of Preventive Medicine, Vol. 28, No. 1, 2005, pp. 9-18.
http://dx.doi.org/10.1016/j.amepre.2004.09.006
[22] L. E. McCurdy, K. E. Winterbottom, S. S. Mehta and J. R. Roberts, “Using Nature and Outdoor Activity to Improve Children’s Health,” Current Problems in Pediatric and Adolescent Health Care, Vol. 40, No. 5, 2010, pp. 102-117. http://dx.doi.org/10.1016/j.cppeds.2010.02.003
[23] M. Kugelmas, D. B. Hill, B. Vivian, L. Marsano and C. J. McClain, “Cytokines and NASH: A Pilot Study of the Effects of Lifestyle Modification and Vitamin E,” Hepatology, Vol. 38, No. 2, 2003, pp. 413-419.
http://dx.doi.org/10.1053/jhep.2003.50316
[24] P. Vajro, C. Mandato, A. Franzese, E. Ciccimarra and S. Lucariello, “Vitamin E Treatment in Pediatric obesity-Related Liver Disease: A Randomized Study,” Journal of Pediatric Gastroenterology and Nutrition, Vol. 38, No. 1, 2004, pp. 48-55.
http://dx.doi.org/10.1097/00005176-200401000-00012
[25] J. H. Hoofnagle, M. L. Van Natta, D. E. Kleiner, J. M. Clark and K. V. Kowdley, “Vitamin E and changes in Serum alanine Aminotransferase Levels in Patients with Non-Alcoholic Steatohepatitis,” Alimentary Pharmacology & Therapeutics, Vol. 38, No. 2, 2013, pp. 134-143.
http://dx.doi.org/10.1111/apt.12352
[26] E. D’Adamo, M. L. Marcovecchio, C. Giannini, T. de Giorgis and V. Chiavaroli, “Improved Oxidative Stress and Cardio-Metabolic Status in Obese Prepubertal Children with Liver Steatosis Treated with Lifestyle Combined with Vitamin E,” Free Radical Research, Vol. 47, No. 3, 2013, pp. 146-153.
http://dx.doi.org/10.3109/10715762.2012.755262
[27] S. A. Harrison, S. Torgerson, P. Hayashi, J. Ward and S. Schenker, “Vitamin E and Vitamin C Treatment Improves Fibrosis in Patients with Nonalcoholic Steatohepatitis,” The American Journal of Gastroenterology, Vol. 98, No. 11, 2003, pp. 2485-2490.
http://dx.doi.org/10.1111/j.1572-0241.2003.08699.x
[28] V. Nobili, M. Manco, R. Devito, P. Ciampalini and F. Piemonte, “Effect of Vitamin E on Aminotransferase Levels and Insulin Resistance in Children with Non-Alcoholic fatty Liver Disease,” Alimentary Pharmacology & Therapeutics, Vol. 24, No. 11-12, 2006, pp. 1553-1561.
http://dx.doi.org/10.1111/j.1365-2036.2006.03161.x
[29] G. Ersoz, F. Gunsar, Z. Karasu, S. Akay, Y. Batur and U. S. Akarca, “Management of Fatty Liver Disease with Vitamin E and C Compared to Ursodeoxycholic Acid Treatment,” The Turkish Journal of Gastroenterology, Vol. 16, No. 3, 2005, pp. 124-128.
[30] T. Foster, M. J. Budoff, S. Saab, N. Ahmadi and C. Gordon, “Atorvastatin and Antioxidants for the Treatment of Nonalcoholic Fatty Liver Disease: The St Francis Heart Study Randomized Clinical Trial,” The American Journal of Gastroenterology, Vol. 106, No. 1, 2011, pp. 71-77.
http://dx.doi.org/10.1038/ajg.2010.299
[31] M. Trauner, T. Claudel, P. Fickert, T. Moustafa and M. Wagner, “Bile Acids as Regulators of Hepatic Lipid and Glucose Metabolism,” Digestive Diseases, Vol. 28, No. 1, 2010, pp. 220-224. http://dx.doi.org/10.1159/000282091
[32] M. Kiyici, M. Gulten, S. Gurel, S. G. Nak, E. Dolar, G. Savci, S. B. Adim, O. Yerci and F. Memik, “Ursodeoxycholic Acid and Atorvastatin in the Treatment of Nonalcoholic Steatohepatitis,” Canadian Journal of Gastroenterology, Vol. 17, No. 12, 2003, pp. 713-718.
[33] K. Madan, Y. Batra, D. S. Gupta, B. Chander and K. D. Anand Rajan, “Vitamin E-Based Therapy Is Effective in Ameliorating Transaminasemia in Nonalcoholic Fatty Liver Disease,” Indian Journal of Gastroenterology, Vol. 24, No. 6, 2005, pp. 251-255.
[34] J. F. Dufour, C. M. Oneta, J. J. Gonvers, F. Bihl, A. Cerny, J. M. Cereda, J. F. Zala, B. Helbling, M. Steuerwald and A. Zimmermann, “Randomized Placebo-Controlled Trial of Ursodeoxycholic Acid with Vitamin E in Nonalcoholic Steatohepatitis,” Clinical Gastroenterology and Hepatology, Vol. 4, No. 12, 2006, pp. 1537-1543.
http://dx.doi.org/10.1016/j.cgh.2006.09.025
[35] T. Cho, Y. J. Kim and S. S. Paik, “The Efficacy of Pharmacological Treatment in Pediatric Nonalcoholic Fatty Liver Disease,” Pediatric Gastroenterology, Hepatology and Nutrition, Vol. 15, No. 4, 2012, pp. 256-265.
http://dx.doi.org/10.5223/pghn.2012.15.4.256
[36] M. L. Balmer, K. Siegrist, A. Zimmermann and J. F. Dufour, “Effects of Ursodeoxycholic Acid in Combination with Vitamin E on Adipokines and Apoptosis in Patients with Nonalcoholic Steatohepatitis,” Liver International, Vol. 29, No. 8, 2009, pp. 1184-1188.
http://dx.doi.org/10.1111/j.1478-3231.2009.02037.x
[37] F. Pietu, O. Guillaud, T. Walter, M. Vallin, V. Hervieu, J. Y. Scoazec and J. Dumortier, “Ursodeoxycholic Acid with vitamin E in Patients with Nonalcoholic Steatohepatitis: Long-Term Results,” Clinics and Research in Hepatology and Gastroenterology, Vol. 36, No. 2, 2012, pp. 146-155. http://dx.doi.org/10.1016/j.clinre.2011.10.011
[38] N. Chalasani, Z. Younossi, J. E. Lavine, A. M. Diehl, E. M. Brunt, K. Cusi, M. Charlton and A. J. Sanyal, “The Diagnosis and Management of Non-Alcoholic Fatty Liver Disease: Practice Guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology,” Gastroenterology, Vol. 142, No. 7, 2012, pp. 1592-1609. http://dx.doi.org/10.1053/j.gastro.2012.04.001
[39] D. Berry, J. K. Wathen and M. Newell, “Bayesian Model Averaging in Meta-Analysis: Vitamin E Supplementation and Mortality,” Clinical Trials, Vol. 6, No. 1, 2009, pp. 28-41. http://dx.doi.org/10.1177/1740774508101279
[40] D. P. Vivekananthan, M. S. Penn, S. K. Sapp, A. Hsu and E. J. Topol, “Use of Antioxidant Vitamins for the Prevention of Cardiovascular Disease: Meta-Analysis of Randomised Trials,” Lancet, Vol. 361, No. 9374, 2003, pp. 2017-2023.
http://dx.doi.org/10.1016/S0140-6736(03)13637-9
[41] J. Gerss and W. Kopcke, “The Questionable Association of Vitamin E Supplementation and Mortality—Inconsistent Results of Different Meta-Analytic Approaches,” Cellular and Molecular Biology (Noisy-le-Grand), Vol. 55(Suppl), 2009, pp. OL1111-OL1120.
[42] G. Bjelakovic, D. Nikolova, L. L. Gluud, R. G. Simonetti, and C. Gluud, “Mortality in Randomized Trials of Antioxidant Supplements for Primary and Secondary Prevention: Systematic Review and Meta-Analysis,” JAMA, Vol. 297, No. 8, 2007, pp. 842-857.
http://dx.doi.org/10.1001/jama.297.8.842
[43] E. R. Miller III, R. Pastor-Barriuso, D. Dalal, R. A. Riemersma, L. J. Appel and E. Guallar, “Meta-Analysis: HighDosage Vitamin E Supplementation May Increase All-Cause Mortality,” Annals of Internal Medicine, Vol. 142, No. 1, 2005, pp. 37-46.
http://dx.doi.org/10.7326/0003-4819-142-1-200501040-00110
[44] H. D. Sesso, J. E. Buring, W. G. Christen, T. Kurth, C. Belanger, J. MacFadyen, V. Bubes, J. E. Manson, R. J. Glynn and J. M. Gaziano, “Vitamins E and C in the Prevention of Cardiovascular Disease in Men: The Physicians’ Health Study II Randomized Controlled Trial,” JAMA, Vol. 300, No. 18, 2008, pp. 2123-2133.
http://dx.doi.org/10.1001/jama.2008.600
[45] E. A. Klein, I. M. Thompson Jr., C. M. Tangen, J. J. Crowley, M. S. Lucia, P. J. Goodman, et al., “Vitamin E and the Risk of Prostate Cancer: The Selenium and Vitamin E Cancer Prevention Trial (SELECT),” JAMA, Vol. 306, No. 14, 2011, pp. 1549-1556.
http://dx.doi.org/10.1001/jama.2011.1437

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