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

Pervez, Muhammad Amjad; Khan, Dishad Ahmet; Ijaz, Aamir; Khan, Shamrez

doi:10.5152/tjg.2018.17297

Cited by 45 publications

(47 citation statements)

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“…Moreover, two eligible articles were published on the same dataset 35,61 , of which the more complete one was included 35 and the other one was excluded 61 . After these exclusions, 33 eligible RCTs remained for inclusion in the current systematic review and meta-analysis ; out of them, 26 studies assessed serum concentrations of CRP 11,[13][14][15][16][17][18][19][20]22,[25][26][27][28][29][30][31][33][34][35]37,38,[40][41][42][43] , 14 studies assessed serum concentrations of IL-6 17,[20][21][22][23][26][27][28][29][30][31]33,37,38 , and 12 studies evaluated serum concentrations of tumor necrosis factor-α (TNF-α) following vitamin E supplementation 12,17,20,…”

Section: Resultsmentioning

confidence: 99%

“…RCTs included in the current systematic review and meta-analysis are illustrated in Table 1. These RCTs were published between 2000 and 2018 and were from the USA 14,20,27,29,42,43 , Europe 13,15,19,21,22 , Asia 11,18,[23][24][25][26]28,[30][31][32][33][34][35][36][37][39][40][41] , Canada 12 , and Australia 16,17,38 . Four studies were exclusively performed on male subjects 23,24,28,35 and others on both genders.…”

Section: Characteristics Of the Included Studies The Characteristicsmentioning

confidence: 99%

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The effect of vitamin E supplementation on selected inflammatory biomarkers in adults: a systematic review and meta-analysis of randomized clinical trials

Asbaghi

Sadeghian

Nazarian

et al. 2020

Sci Rep

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The previous meta-analysis of clinical trials revealed a beneficial effect of vitamin E supplementation on serum C-reactive protein (CRP) concentrations; however, it is unknown whether this vitamin has the same influence on other inflammatory biomarkers. Also, several clinical trials have been published since the release of earlier meta-analysis. Therefore, we aimed to conduct a comprehensive meta-analysis to summarize current evidence on the effects of vitamin E supplementation on inflammatory biomarkers in adults. We searched the online databases using relevant keywords up to November 2019. Randomized clinical trials (RCTs) investigating the effect of vitamin E, compared with the placebo, on serum concentrations of inflammatory cytokines were included. Overall, we included 33 trials with a total sample size of 2102 individuals, aged from 20 to 70 years. Based on 36 effect sizes from 26 RCTs on serum concentrations of CRP, we found a significant reduction following supplementation with vitamin E (− 0.52, 95% CI − 0.80, − 0.23 mg/L, P < 0.001). Although the overall effect of vitamin E supplementation on serum concentrations of interleukin-6 (IL-6) was not significant, a significant reduction in this cytokine was seen in studies that used α-tocopherol and those trials that included patients with disorders related to insulin resistance. Moreover, we found a significant reducing effect of vitamin E supplementation on tumor necrosis factor-α (TNF-α) concentrations at high dosages of vitamin E; such that based on dose–response analysis, serum TNF-α concentrations were reduced significantly at the dosages of ≥ 700 mg/day vitamin E (Pnon-linearity = 0.001). Considering different chemical forms of vitamin E, α-tocopherol, unlike other forms, had a reducing effect on serum levels of CRP and IL-6. In conclusion, our findings revealed a beneficial effect of vitamin E supplementation, particularly in the form of α-tocopherol, on subclinical inflammation in adults. Future high-quality RCTs should be conducted to translate this anti-inflammatory effect of vitamin E to the clinical setting.

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Section: Resultsmentioning

confidence: 99%

Section: Characteristics Of the Included Studies The Characteristicsmentioning

confidence: 99%

The effect of vitamin E supplementation on selected inflammatory biomarkers in adults: a systematic review and meta-analysis of randomized clinical trials

Asbaghi

Sadeghian

Nazarian

et al. 2020

Sci Rep

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“…Moreover, combined vitamin E and vitamin C supplementation for 12 weeks following acute ischemic stroke led to a significant increase in TAC and a significant decrease in CRP and MDA concentrations . Moreover, the ingesting of vitamin E supplements in patients with nonalcoholic fatty liver disease for 12 weeks reduced CRP and MDA levels . Although in some studies, magnesium or vitamin E supplementation did not change CRP levels significantly .…”

Section: Discussionmentioning

confidence: 96%

The effects of magnesium and vitamin E co‐supplementation on wound healing and metabolic status in patients with diabetic foot ulcer: A randomized, double‐blind, placebo‐controlled trial

Afzali

Kashi

Momen‐Heravi

et al. 2019

Wound Repair Regeneration

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This study was carried out to determine the effects of magnesium and vitamin E co-supplementation on wound healing and metabolic status in patients with diabetic foot ulcer (DFU). The current randomized, double-blind, placebo-controlled trial was conducted among 57 patients with grade 3 DFU. Participants were randomly divided into two groups to take either 250 mg magnesium oxide plus 400 IU vitamin E (n = 29) or placebo per day (n = 28) for 12 weeks. Compared with the placebo, taking magnesium plus vitamin E supplements reduced ulcer length (β [difference in the mean of outcomes measures between treatment groups] −0.56 cm; 95% CI, −0.92, −0.20; p = 0.003), width (β −0.35 cm; 95% CI, −0.64, −0.05; p = 0.02) and depth (β −0.18 cm; 95% CI, −0.33, −0.02; p = 0.02). In addition, co-supplementation led to a significant reduction in fasting plasma glucose (β −13.41 mg/dL; 95% CI, −20.96, −5.86; p = 0.001), insulin (β −1.45 μIU/ml; 95% CI, −2.37, −0.52; p = 0.003), insulin resistance (β −0.60; 95% CI, −0.99, −0.20; p = 0.003) and HbA1c (β −0.32%; 95% CI, −0.48, −0.16; p < 0.003), and a significant elevation in insulin sensitivity (β 0.007; 95% CI, 0.003, 0.01; p < 0.001) compared with the placebo. Additionally, compared with the placebo, taking magnesium plus vitamin E supplements decreased triglycerides (β −10.08 mg/dL; 95% CI, −19.70, −0.46; p = 0.04), LDL-cholesterol (β −5.88 mg/dL; 95% CI, −11.42, −0.34; p = 0.03), high sensitivity C-reactive protein (hs-CRP) (β −3.42 mg/L; 95% CI, −4.44, −2.41; p < 0.001) and malondialdehyde (MDA) (β −0.30 μmol/L; 95% CI, −0.45, −0.15; p < 0.001), and increased HDL-cholesterol (β 2.62 mg/dL; 95% CI, 0.60, 4.63; p = 0.01) and total antioxidant capacity (TAC) levels (β 53.61 mmol/L; 95% CI, 4.65, 102.57; p = 0.03). Overall, magnesium and vitamin E co-supplementation for 12 weeks to patients with DFU had beneficial effects on ulcer size, glycemic control, triglycerides, LDL-and HDL-cholesterol, hs-CRP, TAC, and MDA levels.The diabetic foot ulcer (DFU) is a chronic consequence of diabetes mellitus which mainly caused by neuropathy, different grades of ischemia, and infection that coincide with poor glycemic control and diminished neutrophil function. 1 The mortality rate among diabetic patients with DFU is higher than twofold compared with nonulcer patients. 2 Based on the previous evidence, the effective management of diabetes and timely treatment of foot ulcer are implicated for decrease the morbidity and mortality of DFU. 3 The nutritional status of diabetic patients correlates with the severity of ulcer and play an important role in the reversing of wound risk. 4 According to the prior studies, the alternation of magnesium metabolism is a common feature in diabetic patients which interference with glycemic control and contributes to impaired insulin sensitivity and chronic inflammatory status. 5In addition, observational evidence shown that there is an inverse association between magnesium levels and the occurrence of foot ulcers, nephropathy and retinopathy. 6 Similarly, it is repo...

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“…NF-κB is a nuclear transcription factor and could induce the expressions of many genes such as in apoptosis, viral replication, tumorigenesis and various autoimmune diseases. The expression of these large numbers of genes plays an important part in the regulation of health [ 49 , 50 ]. NF-κB up-regulates the protein expressions of TNF-α, IL-6 and iNOS [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

The Liver Protection Effects of Maltol, a Flavoring Agent, on Carbon Tetrachloride-Induced Acute Liver Injury in Mice via Inhibiting Apoptosis and Inflammatory Response

et al. 2018

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The purpose of this research was to evaluate whether maltol could protect from hepatic injury induced by carbon tetrachloride (CCl4) in vivo by inhibition of apoptosis and inflammatory responses. In this work, maltol was administered at a level of 100 mg/kg for 15 days prior to exposure to a single injection of CCl4 (0.25%, i.p.). The results clearly indicated that the intrapulmonary injection of CCl4 resulted in a sharp increase in serum aspartate transaminase (AST) and alanine transaminase (ALT) activities, tumor necrosis factor-α (TNF-α), irreducible nitric oxide synthase (iNOS), nuclear factor-kappa B (NF-κB) and interleukin-1β (IL-1β) levels. Histopathological examination demonstrated severe hepatocyte necrosis and the destruction of architecture in liver lesions. Immunohistochemical staining and western blot analysis suggested an accumulation of iNOS, NF-κB, IL-1β and TNF-α expression. Maltol, when administered to mice for 15 days, can significantly improve these deleterious changes. In addition, TUNEL and Hoechst 33258 staining showed that a liver cell nucleus of a model group diffused uniform fluorescence following CCl4 injection. Maltol pretreatment groups did not show significant cell nuclear condensation and fragmentation, indicating that maltol inhibited CCl4-induced cell apoptosis. By evaluating the liver catalase (CAT), glutathione (GSH), superoxide dismutase (SOD) activity, and further using a single agent to evaluate the oxidative stress in CCl4-induced hepatotoxicity by immunofluorescence staining, maltol dramatically attenuated the reduction levels of hepatic CAT, GSH and SOD, and the over-expression levels of CYP2E1 and HO-1. In the mouse model of CCl4-induced liver injury, we have demonstrated that the inflammatory responses were inhibited, the serum levels of ALT and AST were reduced, cell apoptosis was suppressed, and liver injury caused by CCl4 was alleviated by maltol, demonstrating that maltol may be an efficient hepatoprotective agent.

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

Abstract: 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.

Cited by 45 publications

References 20 publications

The effect of vitamin E supplementation on selected inflammatory biomarkers in adults: a systematic review and meta-analysis of randomized clinical trials

The effect of vitamin E supplementation on selected inflammatory biomarkers in adults: a systematic review and meta-analysis of randomized clinical trials

The effects of magnesium and vitamin E co‐supplementation on wound healing and metabolic status in patients with diabetic foot ulcer: A randomized, double‐blind, placebo‐controlled trial

The Liver Protection Effects of Maltol, a Flavoring Agent, on Carbon Tetrachloride-Induced Acute Liver Injury in Mice via Inhibiting Apoptosis and Inflammatory Response

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