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Randomized Controlled Trial
. 2018 Mar;29(2):170-176.
doi: 10.5152/tjg.2018.17297.

Effects of Delta-tocotrienol Supplementation on Liver Enzymes, Inflammation, Oxidative stress and Hepatic Steatosis in Patients with Nonalcoholic Fatty Liver Disease

Muhammad Amjad Pervez  1 , Dishad Ahmet Khan  1 , Aamir Ijaz  1 , Shamrez Khan  2
Affiliations
Randomized Controlled Trial

Effects of Delta-tocotrienol Supplementation on Liver Enzymes, Inflammation, Oxidative stress and Hepatic Steatosis in Patients with Nonalcoholic Fatty Liver Disease

Muhammad Amjad Pervez et al. Turk J Gastroenterol. 2018 Mar.

Abstract

Background/aims: Non-alcoholic fatty liver disease (NAFLD) is a growing public health problem worldwide and is associated with increased morbidity and mortality. Currently, there is no definitive treatment for this disease. δ-Tocotrienol has potent anti-inflammatory and antioxidant properties and may reduce liver injury in NAFLD. The present study aims to evaluate the efficacy and safety of δ-tocotrienol in the treatment of NAFLD.

Materials and methods: The present study was a randomized, double-blind, placebo-controlled pilot study conducted in patients aged > 20 years, belonging to both sexes, having ultrasound-proven fatty liver disease, having a fatty liver index (FLI) of ≥ 60, and persistent elevation of alanine transaminase. A total of 71 patients were assigned to receive either oral δ-tocotrienol (n=35, 300 mg twice daily) or placebo (n=36) for 12 weeks. At the baseline and at the end of the study, clinical and biochemical parameters, including lipid profile, liver function tests, high-sensitivity C-reactive protein (hs-CRP), and malondialdehyde (MDA) were measured. Body mass index and FLI were calculated, and ultrasound grading of hepatic steatosis was performed.

Results: Out of 71 enrolled patients, 64 patients, 31 in the δ-tocotrienol group and 33 in the placebo group, completed the study. After 12 weeks of supplementation, δ-tocotrienol showed greater efficacy than placebo by decreasing serum aminotransferases, hs-CRP, MDA, and FLI score (p<0.001). However, it did not improve hepatic steatosis on ultrasound examination. No adverse effects were reported.

Conclusion: δ-Tocotrienol was safe, and it effectively improved aminotransferase levels and inflammatory and oxidative stress markers in patients with NAFLD. Large-scale randomized clinical trials are warranted to further support these findings.

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Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1
Trial flow diagram
Figure 2
Figure 2
Serum alanine transaminase (ALT) and fatty liver index (FLI) before and after intervention. p<0.001 for comparison of baseline value to the 12 week value in the δ-tocotrienol group; *p<0.001 for comparison of the δ-tocotrienol group with the placebo group at the end of intervention; T bars denote standard error of means (SEM)
Figure 3
Figure 3
High-sensitivity C-reactive protein (hs-CRP) and malondialdehyde (MDA) before and after intervention; p<0.001 for comparison of baseline value to week 12 value in the δ-tocotrienol group; *p<0.001 for comparison of the δ-tocotrienol group with the placebo group at the end of intervention; T bars denote standard error of means (SEM)
See this image and copyright information in PMC

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