Vitamin E May Alleviate Symptoms of Liver Disease Brought on by Obesity

Story at-a-glance

  • Vitamin E may help relieve the majority of symptoms associated with nonalcoholic steatohepatitis (NASH), a common obesity-related fatty liver disease
  • With no known treatment – and often no symptoms until serious damage has    occurred – Continue reading

Coffee Consumption Reduces Fibrosis Risk in those with Fatty Liver Disease

Increased coffee intake significantly decreases risk in nonalcoholic steatohepatitis patients Continue reading

New Gene Sites Affecting Non Alcoholic Fatty Liver Disease Discovered

NAFLD is a condition where fat accumulates in the liver (steatosis) and can lead to liver inflammation (nonalcoholic steatohepatitis or NASH) and permanent liver damage (fibrosis/cirrhosis). NAFLD affects anywhere from 11% to 45% of some populations and is associated with obesity, hypertension, and problems regulating serum lipids or glucose.

“These findings will help us to better diagnose, manage, and treat NAFLD in the future and help explain why some but not all people with obesity develop particular complications of obesity; some carry genetic variants that predispose them to some but not other metabolic diseases.” says lead author Elizabeth K. Speliotes, M.D., Ph.D., M.P.H., an Assistant Professor of Gastroenterology, Internal Medicine, and Computational Medicine Continue reading

Vitamin E Effective For “Silent” Liver Disease


Vitamin E has been shown effective in treating nonalcoholic steatohepatitis (NASH), an obesity-associated chronic liver disease that can lead to cirrhosis, liver cancer, and death. NASH also is related to or a part of type 2 diabetes, lipid disorders and cardiovascular disease.

The often asymptomatic condition affects 2 to 5 percent of Americans, although an additional 10 to 20 percent of the population has fat in their liver, but no inflammation or liver damage, a condition called “fatty liver” that is a precursor to NASH. There is no established treatment.

The government-funded multicenter study was organized by the Nonalcoholic Steatohepatitis Clinical Research Network of the National Institute of Diabetes and Digestive and Kidney Diseases, and is the largest ever placebo-controlled randomized trial of treatment for NASH. Results are published in the April 28 online edition of the New England Journal of Medicine.

Beginning in the late 1990s, study of vitamin E for NASH was pioneered in pilot trials by Dr. Joel Lavine, now a faculty member in the Department of Pediatrics at Columbia University College of Physicians and Surgeons and chief of gastroenterology, hepatology and nutrition at NewYork-Presbyterian/Morgan Stanley Children’s Hospital. Researchers followed patients at nine centers, including the University of California, San Diego, where Dr. Lavine was previously on faculty.

“There is an increasing prevalence of nonalcoholic steatohepatitis in this country, something that is directly related to the obesity epidemic,” says Dr. Lavine, co-chair of the Network’s steering committee and a co-author of the study. “The good news is that this study showed that cheap and readily available vitamin E can help many of those with the condition. We also looked at the drug pioglitazone, which showed some benefits, although not as dramatic as with vitamin E.”

Dr. Lavine cautions that there are risks with any therapy, even vitamin E, and all treatment should be done under medical supervision. “Individuals who are overweight or have a family history of liver disease should ask their doctor to be tested for the condition. In addition, physicians should be aware that liver enzyme levels considered normal are actually elevated. Healthy levels are <30 U/L for a man and <20 for a woman.”

In the Pioglitazone or Vitamin E for NASH Study (PIVENS), investigators randomly assigned 247 nondiabetic adults with biopsy-confirmed NASH to receive vitamin E, pioglitazone or placebo. Vitamin E functions as an antioxidant while pioglitazone improves the sensitivity of cells to insulin, a hormone that controls both sugar and fat metabolism.

After 96 weeks of treatment, vitamin E improved all features of NASH with the exception of the amount of scar tissue in the liver; 43 percent of those treated with vitamin E met the primary endpoint of the trial, which was a composite of the scores for several features of NASH indicative of disease activity, compared with only 19 percent of those who received a placebo. Pioglitazone also improved many features of NASH and met the primary endpoint in 34 percent of individuals who received it but fell short of statistical significance. Pioglitazone treatment led to an average weight gain of 10 pounds over the 96-week duration of this study. Liver enzyme tests, which are commonly used to assess liver injury, also improved in those who received either pioglitazone or vitamin E. However, upon stopping the medications, the liver enzymes worsened again suggesting the need for long-term treatment.