Ersöz Galip, Günşar Fulya, Karasu Zeki, Akay Sinan, Batur Yücel, Akarca Ulus Salih
Department of Gastroenterology, Ege University Medical School, Izmir, Turkey.
Turk J Gastroenterol. 2005 Sep;16(3):124-8.
BACKGROUND/AIMS: Despite a proposed role of oxidative stress in the pathogenesis of nonalcoholic steatohepatitis, antioxidant approaches have not been investigated sufficiently in the therapy of nonalcoholic steatohepatitis. Our aim was to determine whether vitamin E plus C therapy is effective in normalization of liver enzymes compared to ursodeoxycholic acid treatment in patients with fatty liver disease.
This was an open-labeled, prospective, randomized study enrolling patients with histologically proven fatty liver disease who had chronically elevated alanine aminotransferase, despite a three-month reducing diet. Patients consuming alcohol (more than 20 g/day) were excluded. The patients were randomly prescribed either oral vitamin E (600 IU/day) plus vitamin C (500 mg/day) or ursodeoxycholic acid (10 mg/kg/day). Patients were randomized as two groups to receive vitamin E plus vitamin C combination (28 patients, 10 F) or ursodeoxycholic acid treatment (29 patients, 13 F).
There was no significant change in body mass index before and after the treatment in both groups. At the end of six months of therapy, serum aspartate aminotransferase and aminotransferase levels significantly decreased in both treatment options. Vitamin E and C combination was more efficacious on serum aminotransferase levels than ursodeoxycholic acid, but the difference was not significant. Alanine aminotransferase decreased to normal levels in 17 of 27 (63%) and in 16 of 29 patients (55%), respectively, in the two groups. Gamma-glutamyl transpeptidase decreased in patients receiving ursodeoxycholic acid, but no change was obtained in the vitamin-treated patients.
Vitamin E plus C combination treatment is a safe, inexpensive and effective treatment option in patients with fatty liver disease, with results comparable to those obtained with ursodeoxycholic acid. Since more effective new therapeutic options are lacking, patients with fatty liver disease should be encouraged to take vitamin E and C supplements, which are safe and affordable.
背景/目的：尽管氧化应激在非酒精性脂肪性肝炎发病机制中的作用已被提出，但抗氧化治疗方法在非酒精性脂肪性肝炎治疗中的研究尚不充分。我们的目的是确定与熊去氧胆酸治疗相比，维生素E加C疗法对脂肪肝患者肝酶正常化是否有效。
这是一项开放标签、前瞻性、随机研究，纳入经组织学证实患有脂肪肝且丙氨酸转氨酶长期升高的患者，尽管他们已进行了为期三个月的节食。排除饮酒（超过20克/天）的患者。患者被随机分为口服维生素E（600国际单位/天）加维生素C（500毫克/天）组或熊去氧胆酸（10毫克/千克/天）组。患者被随机分为两组，分别接受维生素E加维生素C联合治疗（28例患者，10例女性）或熊去氧胆酸治疗（29例患者，13例女性）。
两组患者治疗前后体重指数均无显著变化。治疗六个月结束时，两种治疗方案的血清天冬氨酸转氨酶和转氨酶水平均显著下降。维生素E和C联合治疗对血清转氨酶水平比熊去氧胆酸更有效，但差异不显著。两组中，分别有27例患者中的17例（63%）和29例患者中的16例（55%）的丙氨酸转氨酶降至正常水平。接受熊去氧胆酸治疗的患者γ-谷氨酰转肽酶下降，但维生素治疗组患者未出现变化。
维生素E加C联合治疗对脂肪肝患者是一种安全、廉价且有效的治疗选择，其结果与熊去氧胆酸相当。由于缺乏更有效的新治疗选择，应鼓励脂肪肝患者服用安全且价格合理的维生素E和C补充剂。
