Department of Radiology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
Department of Internal Medicine, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
Sci Rep. 2022 Aug 18;12(1):14047. doi: 10.1038/s41598-022-18195-8.
The present study is the first effort to evaluate the effects of vitamin B12 supplementation on the serum level of liver enzymes, homocysteine, grade of hepatic steatosis, and metabolic profiles in patients with non-alcoholic fatty liver disease (NAFLD). Forty patients with NAFLD were enrolled in a double-blind placebo-controlled trial to receive either one oral tablet of vitamin B12 (1000 µg cyanocobalamin) or a placebo per day for 12 weeks. We investigated serum levels of homocysteine, aminotransferases, fasting blood glucose (FBG), lipids, malondialdehyde (MDA), and homeostasis model assessment of insulin resistance (HOMA-IR). The grade of liver steatosis and fibrosis was measured by real-time 2-dimensional shear wave elastography. Vitamin B12 supplementation significantly decreased serum levels of homocysteine compared to placebo (medians: - 2.1 vs. - 0.003 µmol/l; P = 0.038). Although serum alanine transaminase (ALT) in the vitamin B12 group decreased significantly, this change did not reach a significant level compared to the placebo group (medians: - 7.0 vs. 0.0 IU/l; P > 0.05). Despite the significant within-group decrease in FBG, MDA, and liver steatosis in the vitamin B12 group, between-group comparisons did not reveal any significant difference. Vitamin B12 supplementation might decrease serum levels of homocysteine in patients with NAFLD. The fasting blood glucose and serum levels of MDA were significantly improved in the trial group who received vitamin B12. However, these changes did not reach a significant level compared to the placebo group. In this respect, further studies with larger sample sizes, different doses, and types of vitamin B12 will reveal additional evidence.Trial Registration: At http://irct.ir/ as IRCT20120718010333N5 on December 25, 2019.
本研究首次评估了补充维生素 B12 对非酒精性脂肪性肝病（NAFLD）患者血清肝酶、同型半胱氨酸、肝脂肪变性程度和代谢谱的影响。40 例 NAFLD 患者被纳入一项双盲安慰剂对照试验，每天接受 1 片维生素 B12（1000μg 氰钴胺）或安慰剂，共 12 周。我们检测了同型半胱氨酸、氨基转移酶、空腹血糖（FBG）、血脂、丙二醛（MDA）和胰岛素抵抗稳态模型评估（HOMA-IR）。实时二维剪切波弹性成像测量肝脂肪变性和纤维化程度。与安慰剂相比，维生素 B12 补充显著降低了血清同型半胱氨酸水平（中位数：-2.1 对-0.003μmol/L；P=0.038）。虽然维生素 B12 组血清丙氨酸氨基转移酶（ALT）显著下降，但与安慰剂组相比，这一变化无显著差异（中位数：-7.0 对 0.0IU/L；P>0.05）。尽管维生素 B12 组 FBG、MDA 和肝脂肪变性均显著降低，但组间比较无显著差异。维生素 B12 补充可能降低 NAFLD 患者的血清同型半胱氨酸水平。接受维生素 B12 的试验组空腹血糖和 MDA 血清水平显著改善。然而，与安慰剂组相比，这些变化没有达到显著水平。在这方面，进一步的研究需要更大的样本量、不同的剂量和类型的维生素 B12，以揭示更多的证据。试验注册：于 2019 年 12 月 25 日在 http://irct.ir/ 登记，注册号为 IRCT20120718010333N5。
