Author:
Kugelmas, M, et al: Hepatology 2003; 38: 413-19
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Date Posted: Tue, July 29 2003, 7:24:55 PDT
The effects of lifestyle modification and vitamin E on cytokines and NASH cholesterol
Lifestyle modifications may improve liver enzymes, , and plasma hyaluronic acid levels in patients with NASH, finds a team of investigators in the August issue of Hepatology
There is little information on plasma or peripheral blood monocyte cytokine concentrations and production. Nor is there data on attempts to manipulate proinflammatory cytokines in nonalcoholic steatohepatitis (NASH).
In this study, physicians from the United States evaluated the effects of diet and aerobic exercise on cytokine profiles and liver enzyme levels.
They examined the effects both with and without 800 IU of vitamin E daily.
The team assessed 16 patients with biopsy-proven NASH.
The researchers found that liver function, lipid profiles, and body mass index significantly improved during the first 6 weeks of therapy. These then remained stable during the following 6 weeks.
There appeared to be no independent effects of vitamin E supplementation.
In addition, the team determined that plasma hyaluronic acid (HA) concentrations decreased in parallel with weight loss.
The team also found that plasma tumor necrosis factor (TNF) concentrations were significantly elevated in patients with NASH. These were found to be similar to patients with stable alcoholic cirrhosis, but were not as
elevated as in patients with acute alcoholic steatohepatitis (AH).
In addition, they found that although plasma TNF, interleukin 8 (IL-8), and IL-6 concentrations were all elevated, only plasma IL-6 levels significantly decreased with therapy.
The peripheral blood monocyte TNF, IL-8, and IL-6 production was also significantly elevated in patients with NASH, but the team found that this did not significantly decrease.
They were unable to identify any independent effects of vitamin E in these patients.
Dr Marcelo Kugelmas's team concluded, "Patients with NASH have dysregulated cytokine metabolism similar to, but less pronounced than abnormalities documented in AH".
"Cytokine values generally did not decrease significantly with weight loss
with or without vitamin E over the duration of the study".
"Lifestyle modifications--were associated with improvement in liver enzymes, cholesterol, and plasma HA levels in patients with NASH".
"Vitamin E supplementation used in this short-term pilot study provided no apparent added benefit".
Hepatology 2003; 38: 413-19
29 July 2003
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