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Effect of vitamin E on aminotransferase levels and insulin resistance in children with non‐alcoholic fatty liver disease
Author(s) -
NOBILI V.,
MANCO M.,
DEVITO R.,
CIAMPALINI P.,
PIEMONTE F.,
MARCELLINI M.
Publication year - 2006
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2006.03161.x
Subject(s) - medicine , insulin resistance , fatty liver , ascorbic acid , endocrinology , placebo , vitamin e , gastroenterology , vitamin , insulin , disease , biochemistry , antioxidant , chemistry , pathology , alternative medicine , food science
Summary Background Few data are available on the effect of antioxidants in paediatric non‐alcoholic fatty liver disease (NAFLD). Aim To compare the effect of a nutritional programme alone or combined with alpha‐tocopherol and ascorbic acid on alanine aminotransferase (ALT) levels, and insulin resistance (IR) in biopsy‐proven NAFLD children. Methods In a 12‐month double‐blind placebo study, 90 patients were prescribed a balanced calorie diet (25–30 cal/kg/d), physical exercise, and placebo (group A) or alpha‐tocopherol 600 IU/day plus ascorbic acid 500 mg/day (group B). IR was estimated by the homeostasis model assessment (HOMA‐IR). Results At month 12, ALT (32.67 ± 8.09 vs. 32.18 ± 11.39 IU/L; P = NS), HOMA‐IR (1.52 ± 0.66 vs. 1.84 ± 0.95 IU/L; P = NS), and weight loss (32% vs. 35% of excessive body weight; P = NS) did not differ between the two arms. Among subjects who lost ≥20% of their excessive weight, ALT and body weight percentage changes were significantly related ( r o = 0.260; P = 0.03). In subjects, who lost more than 1.0 kg, HOMA‐IR significantly decreased (2.20 ± 0.21 to 1.57 ± 0.13 in group A ( P ≤ 0.01; −8%); 2.91 ± 0.24 to 1.88 ± 0.16 in group B (−32%; P ≤ 0.0001)). ALT decreased by 36% (59.13 ± 4.11 vs. 30.27 ± 1.46 IU/L; P ≤ 0.001), and 42% (68.19 ± 5.68 vs. 31.92 ± 1.92 IU/L; P ≤ 0.0001). In a multivariate analysis, fasting insulin changes in group A ( P = 0.012; F = 7.150). Conclusions Diet and physical exercise in NAFLD children seem to lead to a significant improvement of liver function and glucose metabolism beyond any antioxidant therapy.