Division of Gastrohepatology, Department of Medicine, Chiang Mai University, Thailand.
J Gastroenterol Hepatol. 2009 Jun;24(6):1045-50. doi: 10.1111/j.1440-1746.2009.05865.x.
Glutathione (GSH) depletion contributes to liver injury and development of steatohepatitis. Undenatured cysteine-rich whey protein isolate has been clinically proven to raise GSH in several patient groups. The aim of this study was to evaluate the effect of oral supplementation with whey protein on patients with nonalcoholic steatohepatitis (NASH).
In an open-labeled clinical trial, 38 patients (18 male, 20 female; mean age 48 +/- 14 years) with NASH confirmed by computed tomography measurements and liver biochemistries were given with a daily dose of 20 g whey protein isolate for 12 weeks.
A significant reduction in alanine aminotransferase (ALT) (64 +/- 72 vs 46 +/- 36, P = 0.016) and aspartate aminotransferase (AST) (45 +/- 49 vs 33 +/- 18, P = 0.047) were observed. Plasma glutathione and total antioxidant capacity increased significantly at the end of study (53 +/- 11 vs 68 +/- 11, P < 0.05 and 1.26 +/- 0.10 vs 2.03 +/- 0.10, P < 0.05). Liver attenuation index improved from -13.4 +/- 11.1 to -9.7 +/- 13.1 (P = 0.048). Hepatic macrovesicular steatosis decreased significantly after 12 weeks of supplementation (33.82 +/- 12.82 vs 30.66 +/- 15.96, P = 0.046). Whey protein isolate was well tolerated. No serious adverse events were observed.
The results indicate that oral supplementation of cysteine-rich whey protein isolate leads to improvements in liver biochemistries, increased plasma GSH, total antioxidant capacity and reduced hepatic macrovesicular steatosis in NASH patients. The results support the role of oxidative stress in the pathogenesis of this disease.
谷胱甘肽（GSH）耗竭可导致肝损伤和脂肪性肝炎的发生。未变性富含半胱氨酸的乳清蛋白分离物已在多个患者群体中被临床证实可升高 GSH。本研究旨在评估口服乳清蛋白补充剂对非酒精性脂肪性肝炎（NASH）患者的影响。
在一项开放性临床试验中，38 名（18 名男性，20 名女性；平均年龄 48 ± 14 岁）经计算机断层扫描测量和肝生化检查证实患有 NASH 的患者，每日给予 20 克乳清蛋白分离物，持续 12 周。
丙氨酸氨基转移酶（ALT）（64 ± 72 与 46 ± 36，P = 0.016）和天冬氨酸氨基转移酶（AST）（45 ± 49 与 33 ± 18，P = 0.047）显著降低。研究结束时，血浆谷胱甘肽和总抗氧化能力显著增加（53 ± 11 与 68 ± 11，P < 0.05 和 1.26 ± 0.10 与 2.03 ± 0.10，P < 0.05）。肝衰减指数从-13.4 ± 11.1 改善至-9.7 ± 13.1（P = 0.048）。补充 12 周后，肝大泡性脂肪变性显著减少（33.82 ± 12.82 与 30.66 ± 15.96，P = 0.046）。乳清蛋白分离物耐受性良好。未观察到严重不良事件。
结果表明，口服富含半胱氨酸的乳清蛋白分离物可改善 NASH 患者的肝功能生化指标，增加血浆 GSH、总抗氧化能力，并减少肝大泡性脂肪变性。结果支持氧化应激在该病发病机制中的作用。
