Get access

Effects of vitamin E treatment on peroxisome proliferator-activated receptor-α expression and insulin resistance in patients with non-alcoholic steatohepatitis: results of a pilot study

Authors

  • F Yakaryilmaz,

    Corresponding author
    1. 1 Department of Internal Medicine, Division of Gastroenterology, University of Kirikkale, School of Medicine, Kirikkale, Departments of 2Pathology and 5Internal Medicine, Division of Gastroenterology, University of Ankara, School of Medicine, Departments of 3Pathology and 6Internal Medicine, Division of Gastroenterology, Gazi University, School of Medicine, and 4Division of Endocrinology and Metabolism, Ministry of Health, Ankara Atatürk Education and Research Hospital, Ankara, Turkey
      Fahri Yakaryilmaz, 1 Sokak 8/13 Abidinpasa, Ankara 06620, Turkey.
      Email: fahriyy67@yahoo.com
    Search for more papers by this author
  • 1 S Guliter,

    1. 1 Department of Internal Medicine, Division of Gastroenterology, University of Kirikkale, School of Medicine, Kirikkale, Departments of 2Pathology and 5Internal Medicine, Division of Gastroenterology, University of Ankara, School of Medicine, Departments of 3Pathology and 6Internal Medicine, Division of Gastroenterology, Gazi University, School of Medicine, and 4Division of Endocrinology and Metabolism, Ministry of Health, Ankara Atatürk Education and Research Hospital, Ankara, Turkey
    Search for more papers by this author
  • 1 B Savas,

    1. 1 Department of Internal Medicine, Division of Gastroenterology, University of Kirikkale, School of Medicine, Kirikkale, Departments of 2Pathology and 5Internal Medicine, Division of Gastroenterology, University of Ankara, School of Medicine, Departments of 3Pathology and 6Internal Medicine, Division of Gastroenterology, Gazi University, School of Medicine, and 4Division of Endocrinology and Metabolism, Ministry of Health, Ankara Atatürk Education and Research Hospital, Ankara, Turkey
    Search for more papers by this author
  • 2 O Erdem,

    1. 1 Department of Internal Medicine, Division of Gastroenterology, University of Kirikkale, School of Medicine, Kirikkale, Departments of 2Pathology and 5Internal Medicine, Division of Gastroenterology, University of Ankara, School of Medicine, Departments of 3Pathology and 6Internal Medicine, Division of Gastroenterology, Gazi University, School of Medicine, and 4Division of Endocrinology and Metabolism, Ministry of Health, Ankara Atatürk Education and Research Hospital, Ankara, Turkey
    Search for more papers by this author
  • 3 R Ersoy,

    1. 1 Department of Internal Medicine, Division of Gastroenterology, University of Kirikkale, School of Medicine, Kirikkale, Departments of 2Pathology and 5Internal Medicine, Division of Gastroenterology, University of Ankara, School of Medicine, Departments of 3Pathology and 6Internal Medicine, Division of Gastroenterology, Gazi University, School of Medicine, and 4Division of Endocrinology and Metabolism, Ministry of Health, Ankara Atatürk Education and Research Hospital, Ankara, Turkey
    Search for more papers by this author
  • 4 E Erden,

    1. 1 Department of Internal Medicine, Division of Gastroenterology, University of Kirikkale, School of Medicine, Kirikkale, Departments of 2Pathology and 5Internal Medicine, Division of Gastroenterology, University of Ankara, School of Medicine, Departments of 3Pathology and 6Internal Medicine, Division of Gastroenterology, Gazi University, School of Medicine, and 4Division of Endocrinology and Metabolism, Ministry of Health, Ankara Atatürk Education and Research Hospital, Ankara, Turkey
    Search for more papers by this author
  • 2 G Akyol,

    1. 1 Department of Internal Medicine, Division of Gastroenterology, University of Kirikkale, School of Medicine, Kirikkale, Departments of 2Pathology and 5Internal Medicine, Division of Gastroenterology, University of Ankara, School of Medicine, Departments of 3Pathology and 6Internal Medicine, Division of Gastroenterology, Gazi University, School of Medicine, and 4Division of Endocrinology and Metabolism, Ministry of Health, Ankara Atatürk Education and Research Hospital, Ankara, Turkey
    Search for more papers by this author
  • 3 H Bozkaya,

    1. 1 Department of Internal Medicine, Division of Gastroenterology, University of Kirikkale, School of Medicine, Kirikkale, Departments of 2Pathology and 5Internal Medicine, Division of Gastroenterology, University of Ankara, School of Medicine, Departments of 3Pathology and 6Internal Medicine, Division of Gastroenterology, Gazi University, School of Medicine, and 4Division of Endocrinology and Metabolism, Ministry of Health, Ankara Atatürk Education and Research Hospital, Ankara, Turkey
    Search for more papers by this author
  • and 5 S Ozenirler 6

    1. 1 Department of Internal Medicine, Division of Gastroenterology, University of Kirikkale, School of Medicine, Kirikkale, Departments of 2Pathology and 5Internal Medicine, Division of Gastroenterology, University of Ankara, School of Medicine, Departments of 3Pathology and 6Internal Medicine, Division of Gastroenterology, Gazi University, School of Medicine, and 4Division of Endocrinology and Metabolism, Ministry of Health, Ankara Atatürk Education and Research Hospital, Ankara, Turkey
    Search for more papers by this author

  • Funding: None

    Potential conflicts of interest: None

Fahri Yakaryilmaz, 1 Sokak 8/13 Abidinpasa, Ankara 06620, Turkey.
Email: fahriyy67@yahoo.com

Abstract

Background: Insulin resistance (IR) is commonly associated with non-alcoholic steatohepatitis (NASH). Peroxisome proliferator-activated receptor-α (PPAR-α) may also play a role in the pathogenesis of NASH. A pivotal role in NASH pathogenesis depends on the hypothesis of increased oxidative stress. The aim of our study was to evaluate the effects of supplemental oral vitamin E, a potent antioxidant, on liver functions, PPAR-α expression and IR in patients with NASH.

Methods: Nine patients with biopsy-proven NASH were given oral vitamin E 800 mg daily for 24 weeks. Liver functions, lipid parameters, IR index with homeostatic metabolic assessment and liver histology and PPAR-α staining index in biopsy specimens were detected before and after the treatment.

Results: Seven patients (78%) had IR initially. After 6 months of therapy in nine patients, fasting insulin improved (P = 0.01), but serum cholesterol, triglyceride, fasting blood glucose levels and body mass index remained unchanged. Aspartate aminotransferase and alanine aminotransferase levels decreased (P = 0.01 and P = 0.01, respectively). IR index with homeostatic metabolic assessment resistance improved (P = 0.01), but PPAR-α staining index did not change (P = 0.37). Although the histological grade of steatosis decreased (P = 0.01), necroinflammation and fibrosis remained unchanged. In seven patients with IR, however, necroinflammation and PPAR-α staining index were improved (P = 0.04 and P = 0.02).

Conclusion: Vitamin E treatment, in addition to its previously shown beneficial effect by suppressing oxidative stress, may also achieve improvement by reducing IR and PPAR-α expression in NASH.

Get access to the full text of this article

Ancillary