Impact of Betaine on Hepatic Fibrosis and Homocysteine in Nonalcoholic Steatohepatitis - A Prospective, Cohort Study

Mukherjee, Sandeep; Bernard, Tamara; Kharbanda, Kusum K.; Barak, Anthony J.; Sorrell, Michael F.; Tuma, Dean J.

doi:10.2174/1876399501103010001

Cited by 9 publications

(8 citation statements)

References 27 publications

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“…In a small pilot study, 1 year of betaine therapy improved AST ( P < 0.02) and ALT ( P < 0.007) as well as the degree of steatosis, necroinflammatory grade, and fibrosis stage 6. In an ongoing study of NASH patients, betaine treatment attenuated ALT concentrations and improved the grades of steatosis, inflammation, and fibrosis 25…”

Section: Discussionmentioning

confidence: 95%

Betaine for nonalcoholic fatty liver disease

et al. 2009

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Based on animal studies and pilot studies in humans, betaine, a methyl donor for the remethylation of homocysteine, may be a therapeutic agent for nonalcoholic steatohepatitis (NASH). We evaluated the safety and efficacy of betaine for patients with NASH and whether betaine positively modified factors postulated to be "second hits" and underlying mechanisms of NASH. We conducted a randomized placebo-control study of 55 patients with biopsy-proven NASH who received either oral betaine (20 g daily) or placebo for 12 months. Pre-and posttreatment variables were analyzed using the paired t test or Wilcoxon rank test. Treatment groups were comparable at baseline. Of the 35 patients (17 betaine, 18 placebo) who completed the study, 34 patients (16 betaine, 18 placebo) underwent posttreatment liver biopsy. Patients randomized to betaine had a decrease in steatosis grade. No intra-or intergroup differences or changes in nonalcoholic fatty liver disease activity score or fibrosis stage were noted. Elevations of insulin, glucose, and proinflammatory cytokines and the reduced antioxidant status noted in NASH patients did not improve with betaine therapy. The antiinflammatory agent adiponectin was significantly reduced in both groups and did not change with therapy. Lastly, S-adenosylhomocysteine was approximately twice normal and was not reduced by betaine therapy. Conclusion: Compared to placebo, betaine improved hepatic steatosis and may protect against worsening steatosis. High-dose betaine supplementation failed to reduce S-adenosylhomocysteine and did not positively affect any of the second hit mechanisms postulated to contribute to NASH that we studied. Although betaine has been proven effective in treating hepatic steatosis in several animal models, translating novel therapeutic options noted in animal studies to humans with NASH will prove challenging.

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Section: Discussionmentioning

confidence: 95%

Betaine for nonalcoholic fatty liver disease

et al. 2009

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“…It is interesting to note that betaine deficiency as seen in animal models of MAFLD has been correlated with increased disease severity, a similar trend to that seen in patients [ 164 ]. Importantly, betaine treatment decreased the grade of histological steatosis, inflammation, and fibrosis in MAFLD patients [ 165 , 166 ]. Migilo et al reported that oral administration of betaine for 8 weeks to MAFLD patients reduced hepatomegaly and liver-injury-marker enzymes [ 167 ].…”

Section: Disease Prevention By Betaine Administrationmentioning

confidence: 99%

Beneficial Effects of Betaine: A Comprehensive Review

Arumugam

Paal

Donohue

et al. 2021

Biology

135

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Medicinal herbs and many food ingredients possess favorable biological properties that contribute to their therapeutic activities. One such natural product is betaine, a stable, nontoxic natural substance that is present in animals, plants, and microorganisms. Betaine is also endogenously synthesized through the metabolism of choline or exogenously consumed through dietary intake. Betaine mainly functions as (i) an osmolyte and (ii) a methyl-group donor. This review describes the major physiological effects of betaine in whole-body health and its ability to protect against both liver- as well as non-liver-related diseases and conditions. Betaine’s role in preventing/attenuating both alcohol-induced and metabolic-associated liver diseases has been well studied and is extensively reviewed here. Several studies show that betaine protects against the development of alcohol-induced hepatic steatosis, apoptosis, and accumulation of damaged proteins. Additionally, it can significantly prevent/attenuate progressive liver injury by preserving gut integrity and adipose function. The protective effects are primarily associated with the regulation of methionine metabolism through removing homocysteine and maintaining cellular SAM:SAH ratios. Similarly, betaine prevents metabolic-associated fatty liver disease and its progression. In addition, betaine has a neuroprotective role, preserves myocardial function, and prevents pancreatic steatosis. Betaine also attenuates oxidant stress, endoplasmic reticulum stress, inflammation, and cancer development. To conclude, betaine exerts significant therapeutic and biological effects that are potentially beneficial for alleviating a diverse number of human diseases and conditions.

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“…In a prospective, cohort study was accomplished for evaluate impact of betaine on liver function tests, homocysteine levels and hepatic fibrosis in NAFLD, conducted by Mukherjee et al 45 , were included 35 patients, but 23 patients completed the study, by to present high liver enzymes and biopsy-proven NAFLD for BRUNT criteria 46 within twelve months of study. Patients used 10 grams/ day of betaine anhydrous for one year.…”

Section: Betainementioning

confidence: 99%

Examination of the scientific evidences for off-label use of medications in non-alcoholic fatty liver disease

Oliveira

Baptista²,

Lima³

et al. 2019

cmbio

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Introduction: non-alcoholic fatty liver disease (NAFLD) is considered to be a representation in the liver of insulin resistance or metabolic syndrome, and is a common cause of chronic hepatitis, which can lead to cirrhosis and hepatocellular carcinoma. Currently, there are no pharmacologic therapies approved by the U.S. Food and Drug Administration (FDA) and National Health Surveillance Agency of Brazil (ANVISA) for the NAFLD treatment. Objective: the aim of this study is to assess the evidences for off-label use of medication in NAFLD. Methodology: a systematic search was made in MEDLINE-PubMed for papers published between January 1990 and December 2017, addressing the off-label use or unlicensed drugs for NAFLD treatment. An integrative review was conducted and the data analyzed thematically. Results: of the 3540 studies retrieved, 50 met the inclusion criteria by to contain information about the off-label prescriptions in NAFLD. In this integrative review of the published literature, off-label treatment of NAFLD was generally associated with good shortterm and long term outcomes. Conclusions: after analyzing the data, may conclude that literature includes studies that provides scientific evidence for the off-label drugs use in NAFLD. The evidence of the evaluated studies, suggest that metformin treatment has best effect on reducing hepatocyte fat deposition with regard to other drugs evaluated. However, randomized, placebo controlled studies should be performed to confirm this evidence.

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Impact of Betaine on Hepatic Fibrosis and Homocysteine in Nonalcoholic Steatohepatitis - A Prospective, Cohort Study

Cited by 9 publications

References 27 publications

Betaine for nonalcoholic fatty liver disease

Betaine for nonalcoholic fatty liver disease

Beneficial Effects of Betaine: A Comprehensive Review

Examination of the scientific evidences for off-label use of medications in non-alcoholic fatty liver disease

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