Efficacy of Sea Buckthorn Therapy in Patients with Nonalcoholic Fatty Liver Disease

Zeli Gao^1*, Cheng Zhang², Liwen Jin², Wei Yao²

¹Department of Gastroenterology, People’s Hospital of Pudong New Area, Shanghai, China.
²Department of Gastroenterology, Zhoupu Hospital, Pudong New Area, Shanghai, China.

DOI: 10.4236/cm.2014.54027                

Abstract

Aim: To evaluate the clinical efficacy of the traditional Chinese medicine sea buckthorn (SBT) in the treatment of patients with nonalcoholic fatty liver disease (NAFLD). Method: 94 patients with NAFLD were randomly divided into two groups: 48 cases of patients received oral sea buckthorn 1.5 g (3 times a day) for three months as the treated group, and 46 cases received only the vehicle for three months as the control group. Serum lipids, transaminase and serum liver fibrosis indices were assessed at baseline and after SBT treatment. All patients underwent liver CT and Fibroscan examination at baseline and after treatment. Results: SBT treatment resulted in a significant decrease in the serum levels of alanine aminotransferase (ALT), LDL-C, hyaluronic acid and collagen type IV. The liver stiffness measurement (LSM) of the treated patients was significantly lower than that in the control or baseline. The CT liver/spleen ratio of the treated patients was also significantly increased. Conclusion: The results of our study demonstrated the beneficial effects of SBT on serum lipids, transaminase, and liver/spleen ratio and liver stiffness in patients with NAFLD, which may be further developed as a promising therapy for the treatment of NAFLD.

Keywords

Sea Buckthorn (Hippophae rhamnoides L), Nonalcoholic Fatty Liver Disease, Blood Lipid, Traditional Chinese Medicine

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Park, H., Shima, T., Yamaguchi, K., et al. (2011) Efficacy of Long-Term Ezetimibe Therapy in Patients with Nonalcoholic Fatty Liver Disease. Journal of Gastroenterology, 46, 101-107. http://dx.doi.org/10.1007/s00535-010-0291-8
[2]	Smith, B.W. and Adams, L.A. (2011) Non-Alcoholic Fatty Liver Disease. Critical Reviews in Clinical Laboratory Sciences, 48, 97-113. http://dx.doi.org/10.3109/10408363.2011.596521
[3]	Fon Tacer, K. and Rozman, D. (2011) Nonalcoholic Fatty Liver Disease: Focus on Lipoprotein and Lipid Deregulation. Journal of Lipids, 2011, Article ID: 783976. http://dx.doi.org/10.1155/2011/783976
[4]	Targher, G., Bertolini, L. and Poli, F. (2005) Nonalcoholic Fatty Liver Disease and Risk of Future Cardiovascular Events among Type 2 Diabetic Patients. Diabetes, 54, 3541-3546. http://dx.doi.org/10.2337/diabetes.54.12.3541
[5]	Chuthan Sourianarayanane, A., Pagadala, M.R. and Kirwan, J.P. (2013) Management of Non-Alcoholic Fatty Liver Disease. Minerva Gastroenterologica e Dietologica, 59, 69-87.
[6]	Kruczek, M., Swiderski, A., Mech-Nowak, A., et al. (2012) Antioxidant Capacity of Crude Extracts Containing Carotenoids from the Berries of Various Cultivars of Sea Buckthorn (Hippophae rhamnoides L). Acta Biochimica Polonica, 59, 135-137.
[7]	Ganju, L., Padwad, Y., Singh, R., Karan, D., Chanda, S., Chopra, M.K., Bhatnagar, P., Kashyap, R. and Sawhney, R.C. (2005) Anti-Inflammatory Activity of Seabuckthorn (Hippophae rhamnoides) Leaves. International Immunopharmacology, 5, 1675-1684. http://dx.doi.org/10.1016/j.intimp.2005.03.017
[8]	Padwad, Y., Ganju, L., Jain, M., Chanda, S., Karan, D., Kumar, R., Banerjee, P.K. and Sawhney, R.C. (2006) Effect of Leaf Extract of Sea Buckthorn on Lipopolysaccharide Induced Inflammatory Response in Murine Macrophages. International Immunopharmacology, 6, 46-52. http://dx.doi.org/10.1016/j.intimp.2005.07.015
[9]	Wang, J., Zhang, W., Zhu, D., et al. (2011) Hypolipidaemic and Hypoglycaemic Effects of Total Flavonoids from Seed Residues of Hippophae rhamnoides L in Mice Fed a High-Fat Diet. Journal of the Science of Food and Agriculture, 91, 1446-1451. http://dx.doi.org/10.1002/jsfa.4331
[10]	Geetha, S., Jayamurthy, P., Pal, K., Pandey, S. and Sawhney, R.C. (2008) Hepatoprotective Activity of Sea Buckthorn (Hippophae rhamnoides L) against Carbon Tetrachloride Induced Hepatic Damage in Rats. Journal of Science of Food and Agriculture, 88, 1592-1597. http://dx.doi.org/10.1002/jsfa.3255
[11]	Hsu, Y.W., Tsai, C., Chen, W.K. and Lu, F.J. (2009) Protective Effects of Seabuckthorn (Hippophae rhamnoides L) Seed Oil against Carbon Tetrachloride-Induced Hepatotoxicity in Mice. Food and Chemical Toxicology, 47, 22812288. http://dx.doi.org/10.1016/j.fct.2009.06.015
[12]	Sandrin, L., Tanter, M., Gennisson, J.L., Catheline, S. and Fink, M. (2002) Shear Elasticity Probe for Soft Tissues with 1-D Transient Elastography. IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control, 49, 436-446. http://dx.doi.org/10.1109/58.996561
[13]	Sandrin, L., Fourquet, B., Hasquenoph, J.M., Yon, S., Fournier, C., Mal, F., et al. (2003) Transient Elastography: A New Noninvasive Method for Assessment of Hepatic Fibrosis. Ultrasound in Medicine and Biology, 29, 1705-1713. http://dx.doi.org/10.1016/j.ultrasmedbio.2003.07.001
[14]	Oliva, M.R., Mortele, K.J., Segatto, E., Glickman, J.N., Erturk, S.M., Ros, P.R. and Silverman, S.G. (2006) Computed Tomography Features of Nonalcoholic Steatohepatitis with Histopathologic Correlation. Journal of Computer Assisted Tomography, 30, 37-43. http://dx.doi.org/10.1097/01.rct.0000193818.31749.84
[15]	Tobari, M., Hashimoto, E., Yatsuji, S., Torii, N. and Shiratori, K. (2009) Imaging of Nonalcoholic Steatohepatitis: Advantages and Pitfalls of Ultrasonography and Computed Tomography. Internal Medicine, 48, 739-746. http://dx.doi.org/10.2169/internalmedicine.48.1869
[16]	Castera, L., Forns, X. and Alberti, A. (2008) Non-Invasive Evaluation of Liver Fibrosis Using Transient Elastography. Journal of Hepatology, 48, 835-847. http://dx.doi.org/10.1016/j.jhep.2008.02.008
[17]	Mahadeva, S., Mahfudz, A.S., Vijayanathan, A., Goh, K.L., Kulenthran, A. and Cheah, P.L. (2013) Performance of Transient Elastography (TE) and Factors Associated with Discordance in Nonalcoholic Fatty Liver Disease. Journal of Digestive Diseases, 14, 604-610. http://dx.doi.org/10.1111/1751-2980.12088
[18]	Yoneda, M., Yoneda, M., Mawatari, H., Fujita, K., Endo, H., Iida, H., et al. (2008) Noninvasive Assessment of Liver Fibrosis by Measurement of Stiffness in Patients with Nonalcoholic Fatty Liver Disease (NAFLD). Digestive and Liver Disease, 40, 371-378. http://dx.doi.org/10.1016/j.dld.2007.10.019
[19]	Wang, J., Zhang, W., Zhu, D., Zhu, X.L., Pang, X.F. and Qu, W.J. (2011) Hypolipidaemic and Hypoglycaemic Effects of Total Flavonoids from Seed Residues of Hippophae rhamnoides L in Mice Fed a High-Fat Diet. Journal of the Science of Food and Agriculture, 91, 1446-1451. http://dx.doi.org/10.1002/jsfa.4331
[20]	Smith, B.W. and Adams, L.A. (2011) Non-Alcoholic Fatty Liver Disease. Critical Reviews in Clinical Laboratory Sciences, 48, 97-113. http://dx.doi.org/10.3109/10408363.2011.596521
[21]	Rallidis, L.S., Drakoulis, C.K. and Parasi, A.S. (2004) Pravastatin in Patients with Nonalcoholic Steatohepatitis: Results of a Pilot Study. Atherosclerosis, 174, 193-196. http://dx.doi.org/10.1016/j.atherosclerosis.2004.01.008
[22]	Lewis, J.H. (2012) Clinical Perspective: Statins and the Liver—Harmful or Helpful? Digestive Diseases and Sciences, 57, 1754-1763. http://dx.doi.org/10.1007/s10620-012-2207-3
[23]	Tulsawani, R., Gupta, R. and Misra, K. (2013) Efficacy of Aqueous Extract of Hippophae rhamnoides and Its Bio-Active Flavonoids against Hypoxia-Induced Cell Death. Indian Journal of Pharmacology, 45, 258-263. http://dx.doi.org/10.4103/0253-7613.111943
[24]	Pang, X., Zhao, J., Zhang, W., Zhuang, X.Y., Wang, J.S., Xu, R.Q., Xu, Z.L. and Qu, W.J. (2008) Antihypertensive Effect of Total Flavones Extracted from Seed Residues of Hippophae rhamnoides L in Sucrose-Fed Rats. Journal of Ethnopharmacology, 117, 325-331. http://dx.doi.org/10.1016/j.jep.2008.02.002
[25]	Targher, G., Bertolini, L., Padovani, R., Rodella, S., Zoppini, G., Pichiri, I., et al. (2010) Prevalence of Non-Alcoholic Fatty Liver Disease and Its Association with Cardiovascular Disease in Patients with Type 1 Diabetes. Journal of Hepatology, 53, 713-718. http://dx.doi.org/10.1016/j.jhep.2010.04.030
[26]	Loria, P., Lonardo, A., Bellentani, S., Day, C.P., Marchesini, G. and Carulli, N. (2007) Non-Alcoholic Fatty Liver Disease (NAFLD) and Cardiovascular Disease: An Open Question. Nutrition, Metabolism and Cardiovascular Diseases, 17, 684-698. http://dx.doi.org/10.1016/j.numecd.2007.01.007
[27]	Kremer, M., Thomas, E., Milton, R.J., Perry, A.W., van Rooijen, N., Wheeler, M.D., et al. (2010) Kupffer Cell and Interleukin-12-Dependent Loss of Natural Killer T Cells in Hepatosteatosis. Hepatology, 51, 130-141. http://dx.doi.org/10.1002/hep.23292
[28]	Ganju, L., Padwad, Y., Singh, R., Karan, D., Chanda, S., Chopra, M.K., et al. (2005) Anti-Inflammatory Activity of Seabuckthorn (Hippophae rhamnoides L) Leaves. International Immunopharmacology, 5, 1675-1684. http://dx.doi.org/10.1016/j.intimp.2005.03.017
[29]	Mishra, K.P., Chanda, S., Karan, D., Ganju, L. and Sawhney, R.C. (2008) Effect of Seabuckthorn (Hippophae rhamnoides) Flavone on Immune System: An in Vitro Approach. Phytotherapy Research, 22, 1490-1495. http://dx.doi.org/10.1002/ptr.2518