Therapeutic Effects of Vitamin E in Non-alcoholic Fatty Liver Disease: An Open-Labeled Clinical Trial

Abstract

Non-alcoholic fatty liver disease is one of the widespread chronic liver diseases; it is ranging from simple fat buildup in the liver (steatosis) to non-alcoholic steatohepatitis with the presence of inflammation and hepatocyte injury. Vitamin E is one of the most potent antioxidants, in addition to the antioxidant effect of vitamin E; it has anti-inflammatory and anti-apoptotic properties. Lifestyle modifications are the cornerstone for nonalcoholic fatty liver management to lose weight and reduce hepatic fat content. To assess the effects of vitamin E and lifestyle modifications on the degree of fatty infiltration in the liver, liver enzymes, and lipid profile. This is a prospective pre-post intervention open-labeled clinical trial which was performed in Gastroenterology and Hepatology teaching hospital in Baghdad\Iraq, The duration of this study was seven months from January 2021 to July 2021, (39) Participants were included after being diagnosed with NAFLD by the specialized physician depending on ultrasonography findings, They were administered vitamin E 800IU\day for 12 weeks and advised to take low fat, low carbohydrate diet and increase physical activity. Steatosis score, liver enzymes, fasting serum glucose, and lipid profile were measured at baseline and repeated at 4 weeks and 12weeks of the study period. ANOVA test was used to compare the measures among baseline, 4 weeks, and 12 weeks of the study, least significant difference LSD was used to find out the significant measures, Pearson Chi-Square test was used to compare steatosis score throughout the study. This study found that there is an association between steatosis score and vitamin E use with lifestyle modifications as the score reduced significantly throughout the study (P=0.0001) whereas 46.2% of the participants turned into a score (0) at 12 weeks of the study. Liver enzymes ALT, AST, and ALP did not show significant differences among baseline, 4 weeks, and 12 weeks (P=0.211, P=0.052, and P=0.352 respectively), However, AST showed significant differences between 4 weeks versus12 weeks (P=0.039) and baseline versus 12 weeks (P=0.032). LDL, VLDL, and HDL did not show significant differences among baseline, 4 weeks, and 12 weeks (P=0.569, P=0.195, and P=0.949 respectively) while total cholesterol and triglyceride showed significant difference (P=0.001and P=0.0001 respectively). BMI showed a significant difference between baseline and 12 weeks (P=0.015). Fasting serum glucose did not show a significant difference throughout the study (P=0.122). Vitamin E with lifestyle modifications has beneficial effects for patients with NAFLD as steatosis score, total cholesterol, triglyceride, and BMI had reduced significantly during the study period.