Effect of vitamin E in nonalcoholic fatty liver disease with metabolic syndrome: A propensity score-matched cohort study
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background/Aims: Vitamin E improves the biochemical profiles and liver histology in nonalcoholic steatohepatitis, but the role of vitamin E is not clearly defined in the management of nonalcoholic fatty liver disease (NAFLD) which includes both simple steatosis and steatohepatitis. Co-morbid metabolic syndrome increases the probability of steatohepatitis in NAFLD. In this study, we aimed to determine the short-term effects of vitamin E and off-treatment durability of response in a propensity-score matched cohort of NAFLD patients with metabolic syndrome. Methods: A retrospective cohort was constructed by retrieving 526 consecutive NAFLD patients from the electronic medical record data warehouse of a tertiary referral hospital in South Korea. Among them, 335 patients (63.7%) had metabolic syndrome and were eligible for vitamin E therapy. In order to assess the effect of vitamin E, propensity score matching was used by matching covariates between control patients (n=250) and patients who received vitamin E (n=85). Results: The PS-matched vitamin E group (n=58) and control group (n=58) exhibited similar baseline metabolic profiles. After 6 months of vitamin E therapy, the mean ALT levels decreased significantly compared to PS-matched control (P<0.01). The changes in metabolic profiles (body weight, lipid and glucose levels) did not differ between control and vitamin E groups during the study period. Conclusions: Short-term vitamin E treatment significantly reduces ALT levels in NAFLD patients with metabolic syndrome, but metabolic profiles are not affected by vitamin E.
Abstract
Background/Aims: Vitamin E improves the biochemical profiles and liver histology in nonalcoholic steatohepatitis, but the role of vitamin E is not clearly defined in the management of nonalcoholic fatty liver disease (NAFLD) which includes both simple steatosis and steatohepatitis. Co-morbid metabolic syndrome increases the probability of steatohepatitis in NAFLD. In this study, we aimed to determine the short-term effects of vitamin E and off-treatment durability of response in a propensity-score matched cohort of NAFLD patients with metabolic syndrome. Methods: A retrospective cohort was constructed by retrieving 526 consecutive NAFLD patients from the electronic medical record data warehouse of a tertiary referral hospital in South Korea. Among them, 335 patients (63.7%) had metabolic syndrome and were eligible for vitamin E therapy. In order to assess the effect of vitamin E, propensity score matching was used by matching covariates between control patients (n=250) and patients who received vitamin E (n=85). Results: The PS-matched vitamin E group (n=58) and control group (n=58) exhibited similar baseline metabolic profiles. After 6 months of vitamin E therapy, the mean ALT levels decreased significantly compared to PS-matched control (P<0.01). The changes in metabolic profiles (body weight, lipid and glucose levels) did not differ between control and vitamin E groups during the study period. Conclusions: Short-term vitamin E treatment significantly reduces ALT levels in NAFLD patients with metabolic syndrome, but metabolic profiles are not affected by vitamin E.
참고문헌 (39)
- Lazo M, "The epidemiology of nonalcoholic fatty liver disease : a global perspective", Semin Liver Dis, 28, pp.339~350 (2008)
- Vernon G, "Systematic review : the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults", Aliment Pharmacol Ther, 34, pp.274~285 (2011)
- Ekstedt M, "Long-term follow-up of patients with NAFLD and elevated liver enzymes", Hepatology, 44, pp.865~873 (2006)
- Wong VW, "Disease progression of non-alcoholic fatty liver disease : a prospective study with paired liver biopsies at 3 years", Gut, 59, pp.969~974 (2010)
- Adams LA, "The natural history of nonalcoholic fatty liver disease : a population-based cohort study", Gastroenterology, 129, pp.113~121 (2005)
- Dunn W, "Suspected nonalcoholic fatty liver disease and mortality risk in a population-based cohort study", Am J Gastroenterol, 103, pp.2263~2271 (2008)
- Chalasani N, "The diagnosis and management of non-alcoholic fatty liver disease: practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association", Hepatology, 55, pp.2005~2023 (2012)
- Browning JD, "Molecular mediators of hepatic steatosis and liver injury", J Clin Invest, 114, pp.147~152 (2004)
- Chang CY, "Therapy of NAFLD:antioxidants and cytoprotective agents", J Clin Gastroenterol, 40(1), pp.S51~S60 (2006)
- Hickman I, "Is vitamin E beneficial in chronic liver disease?", Hepatology, 46, pp.288~290 (2007)
- Pacana T, "Vitamin E and nonalcoholic fatty liver disease", Curr Opin Clin Nutr Metab Care, 15, pp.641~648 (2012)
- Sanyal AJ, "Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis", N Engl J Med, 362, pp.1675~1685 (2010)
- Hoofnagle JH, "Vitamin E and changes in serum alanine aminotransferase levels in patients with non-alcoholic steatohepatitis", Aliment Pharmacol Ther, 38, pp.134~143 (2013)
- Korean Association for the Study of the Liver(, "KASL clinical practice guidelines : management of nonalcoholic fatty liver disease", Clin Mol Hepatol, 19, pp.325~348 (2013)
- Marchesini G, "Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome", Hepatology, 37, pp.917~923 (2003)
- Dixon JB, "Nonalcoholic fatty liver disease : predictors of nonalcoholic steatohepatitis and liver fibrosis in the severely obese", Gastroenterology, 121, pp.91~100 (2001)
- Kang H, "Metabolic syndrome is associated with greater histologic severity, higher carbohydrate, and lower fat diet in patients with NAFLD", Am J Gastroenterol, 101, pp.2247~2253 (2006)
- D’Agostino RB, "Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group", Statistics in Medicine, 17, pp.2265~2281 (1998)
- Hosaka T, "Long-term entecavir treatment reduces hepatocellular carcinoma incidence in patients with hepatitis B virus infection", Hepatology, 58, pp.98~107 (2013)
- Lim YS, "Mortality, liver transplantation, and hepatocellular carcinoma among patients with chronic hepatitis B treated with entecavir vs lamivudine", Gastroenterology, 147, pp.152~161 (2014)
- 유수영, "Seoul National University Bundang Hospital’s Electronic System for Total Care", Healthcare Informatics Research, 18(2), pp.145~152 (2012), 대한의료정보학회[DOI]
- Chalasani N, "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, 142, pp.1592~1609 (2012)
- Grundy SM, "Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute", American Heart Association conference on scientific issues related to definition, 2004, pp.109, 433~438
- Alberti KG, "Metabolic syndrome--a new worldwide definition. A Consensus Statement from the International Diabetes Federation", Diabet Med, 23, pp.469~480 (2006)
- Farrell GC, "Guidelines for the assessment and management of non-alcoholic fatty liver disease in the Asia-Pacific region : executive summary", J Gastroenterol Hepatol, 22, pp.775~777 (2007)
- Angulo P, "The NAFLD fibrosis score : a noninvasive system that identifies liver fibrosis in patients with NAFLD", Hepatology, 45, pp.846~854 (2007)
- Lin ZH, "Performance of the aspartate aminotransferase-to-platelet ratio index for the staging of hepatitis C-related fibrosis : an updated meta-analysis", Hepatology, 53, pp.726~736 (2011)
- Harrison SA, "Orlistat for overweight subjects with nonalcoholic steatohepatitis: A randomized, prospective trial", Hepatology, 49, pp.80~86 (2009)
- Promrat K, "Randomized controlled trial testing the effects of weight loss on nonalcoholic steatohepatitis", Hepatology, 51, pp.121~129 (2010)
- Torres DM, "Features, diagnosis, and treatment of nonalcoholic fatty liver disease", Clin Gastroenterol Hepatol, 10, pp.837~858 (2012)
- Lavine JE, "Effect of vitamin E or metformin for treatment of nonalcoholic fatty liver disease in children and adolescents : the TONIC randomized controlled trial", JAMA, 305, pp.1659~1668 (2011)
- Polyzos SA, "Effect of spironolactone and vitamin E on serum metabolic parameters and insulin resistance in patients with nonalcoholic fatty liver disease", J Renin Angiotensin Aldosterone Syst, 12, pp.498~503 (2011)
- Stern SE, "Identification of individuals with insulin resistance using routine clinical measurements", Diabetes, 54, pp.333~339 (2005)
- Chitturi S, "NASH and insulin resistance : insulin hypersecretion and specific association with the insulin resistance syndrome", Hepatology, 35, pp.373~379 (2002)
- Pagano G, "Nonalcoholic steatohepatitis, insulin resistance, and metabolic syndrome: further evidence for an etiologic association", Hepatology, 35, pp.367~372 (2002)
- Evans JL, "The molecular basis for oxidative stress-induced insulin resistance", Antioxid Redox Signal, 7, pp.1040~1052 (2005)
- Videla LA, "Insulin resistance and oxidative stress interdependency in non-alcoholic fatty liver disease", Trends Mol Med, 12, pp.555~558 (2006)
- Park K, "Oxidative stress and insulin resistance : the coronary artery risk development in young adults study", Diabetes Care, 32, pp.1302~1307 (2009)
- Phung N, "Pro-oxidant-mediated hepatic fibrosis and effects of antioxidant intervention in murine dietary steatohepatitis", Int J Mol Med, 24, pp.171~180 (2009)
