Molaqanbari Mohamad Reza, Zarringol Shadi, Talari Hamid Reza, Taghizadeh Mohsen, Bahmani Fereshteh, Mohtashamian Abbas, Ebrahimzadeh Armin, Sharifi Nasrin
Department of Internal Medicine, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
Department of Radiology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
Adv Biomed Res. 2023 Apr 27;12:103. doi: 10.4103/abr.abr_90_22. eCollection 2023.
Previous evidence revealed an association between folate deficiency and non-alcoholic fatty liver disease (NAFLD). This study is the first one investigating the effects of folic acid on hepatic steatosis grade, liver enzymes, insulin resistance, and lipid profile in NAFLD cases.
Sixty-six participants with NAFLD were allocated randomly to take either a placebo or one oral tablet of folic acid (1 mg) on a daily basis within eight weeks. Serum folate, homocysteine, glucose, aminotransferases, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), and lipids were assessed. Ultrasonography was used for assessing the liver steatosis grade.
The serum alanine transaminase, grade of hepatic steatosis, and aspartate transaminase significantly were decreased within both study groups; however, the between-group comparison was not statistically significant. Of note, the decrease in ALT was more pronounced in folic acid compared with the placebo group (-5.45 ± 7.45 vs. -2.19 ± 8.6 IU/L). The serum homocysteine was decreased after receiving folic acid compared to the placebo (-0.58 ± 3.41 vs. +0.4 ± 3.56 μmol/L; adjusted = 0.054). Other outcomes did not significantly change.
Supplementation with folic acid (1 mg/d) for eight weeks among cases with NAFLD did not change significantly the serum levels of liver enzymes, the hepatic steatosis grade, insulin resistance and lipid profile. However, it was able to prevent the increase in homocysteine in comparison with the placebo. Conducting further research is suggested with the longer duration and different doses of folic acid, adjusted to the genotypes of methylenetetrahydrofolate reductase polymorphism, among NAFLD patients.
先前的证据显示叶酸缺乏与非酒精性脂肪性肝病（NAFLD）之间存在关联。本研究是首个调查叶酸对NAFLD患者肝脂肪变性分级、肝酶、胰岛素抵抗和血脂谱影响的研究。
66名NAFLD参与者被随机分配，在八周内每日服用安慰剂或一片口服叶酸（1毫克）。评估血清叶酸、同型半胱氨酸、葡萄糖、转氨酶、胰岛素、胰岛素抵抗稳态模型评估（HOMA-IR）和血脂。使用超声检查评估肝脏脂肪变性分级。
两个研究组的血清丙氨酸转氨酶、肝脂肪变性分级和天冬氨酸转氨酶均显著降低；然而，组间比较无统计学意义。值得注意的是，与安慰剂组相比，叶酸组的ALT下降更为明显（-5.45±7.45对-2.19±8.6 IU/L）。与安慰剂相比，服用叶酸后血清同型半胱氨酸降低（-0.58±3.41对+0.4±3.56 μmol/L；校正P=0.054）。其他结果无显著变化。
NAFLD患者补充叶酸（1毫克/天）八周并未显著改变肝酶血清水平、肝脂肪变性分级、胰岛素抵抗和血脂谱。然而，与安慰剂相比，它能够预防同型半胱氨酸升高。建议在NAFLD患者中进行进一步研究，采用更长疗程和不同剂量的叶酸，并根据亚甲基四氢叶酸还原酶多态性的基因型进行调整。
