Association Between Liver Vitamin A Reserves and Severity of Nonalcoholic Fatty Liver Disease in the Class III Obese Following Bariatric Surgery

Chaves, Gabriela Villaça; Pereira, Sílvia; Saboya, Carlos; Spitz, Daiane; Rodrigues, Camila Santos; Ramalho, Andréa

doi:10.1007/s11695-013-1087-8

Cited by 43 publications

(48 citation statements)

References 19 publications

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“…In adults, reduced levels of the hepatic anti-oxidants coenzyme Q10 and glutathione correlated with the severity of NAFLD, as did serum and hepatic retinol stores[4] [57]. In children, reduced serum beta-carotene and alpha tocopherol were associated with NAFLD [58, 59].…”

Section: Discussionmentioning

confidence: 99%

Nocturnal hypoxia-induced oxidative stress promotes progression of pediatric non-alcoholic fatty liver disease

Sundaram

Halbower

Pan

et al. 2016

Journal of Hepatology

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Background Oxidative stress is proposed as a central mediator in NAFLD pathogenesis, but the specific trigger for reactive oxygen species generation has not been clearly delineated. In addition, emerging evidence shows that obesity-related obstructive sleep apnea (OSA) and nocturnal hypoxia are associated with NAFLD progression in adults. Aim To determine if OSA/nocturnal hypoxia induced oxidative stress promotes the progression of pediatric NAFLD. Methods Subjects with biopsy proven NAFLD and lean controls were studied. Subjects underwent polysomnograms, liver histology scoring, laboratory testing, urine F(2)-isoprostanes (measure of lipid peroxidation) and 4-hydroxynonenal liver immunohistochemistry (in situ hepatic lipid peroxidation). Results We studied 36 adolescents with NAFLD and 14 lean controls. The OSA/hypoxia group (69% of NAFLD subjects) had more severe fibrosis (64% Stage 0–2; 36 % Stage 3) than those without OSA/hypoxia (100% Stage 0–2), p=0.03. Higher F(2)-isoprostanes correlated with apnea/hypoxia index (r=0.39, p= 0.03), % time SaO2 <90% (r= 0.56, p=0.0008) and inversely with SaO2 nadir (r=−0.46, p=0.008). OSA/hypoxia was most severe in subjects with the greatest 4HNE staining (p=0.03). Increasing F(2)-isoprostanes(r=0.32, p=0.04) and 4HNE hepatic staining (r=0.47, p=0.007) were associated with worsening steatosis. Greater oxidative stress occurred in subjects with definite NASH as measured by F(2)-isoprostanes (p=0.06) and hepatic 4HNE (p=0.03) compared to those with borderline/not NASH. Conclusions These data support the role of nocturnal hypoxia as a trigger for localized hepatic oxidative stress, an important factor associated with the progression of NASH and hepatic fibrosis in obese pediatric patients.

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Section: Discussionmentioning

confidence: 99%

Nocturnal hypoxia-induced oxidative stress promotes progression of pediatric non-alcoholic fatty liver disease

Sundaram

Halbower

Pan

et al. 2016

Journal of Hepatology

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“…[ 24 – 26 ] Another report showed that hepatic retinol reserves in patients with NASH were lower compared to those with SS. [ 27 ]…”

Section: Introductionmentioning

confidence: 99%

Altered hepatic genes related to retinol metabolism and plasma retinol in patients with non-alcoholic fatty liver disease

et al. 2018

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Non-alcoholic fatty liver disease (NAFLD), especially non-alcoholic steatohepatitis (NASH) is a chronic liver disease commonly associated with hepatic fibrosis. NASH patients have an increased risk for hepatocellular carcinoma (HCC). An altered retinol metabolism is one of the pathways involved in the process of hepatic fibrosis, and enzymes involved in retinol metabolism have been associated with HCC. We aimed to determine the association between plasma retinol levels and hepatic expression of genes related to retinol metabolism, as well as to assess the hepatic expression of transcription factors regulated by retinoic acid in patients with NAFLD. Cross-sectional study where hepatic gene expression (Illumina microarray) and plasma retinol levels (HPLC) were measured in 17 patients with simple steatosis (SS), 15 with NASH, and 22 living liver donors (LD) as controls. Plasma retinol levels were higher in SS (1.53 ± 0.44 μmol/L) and NASH (1.51 ± 0.56 μmol/L) compared to LD (1.21 ± 0.38 μmol/L; p<0.05). AKR1B10 was highly overexpressed in NASH compared to SS (+6.2-fold) and LD (+9.9-fold; p = 4.89E-11). Retinaldehyde dehydrogenase 1 family, member A2 (ALDH1A2) and retinaldehyde dehydrogenase 1 family, member A3 (ALDH1A3), key enzymes for retinoic acid synthesis, were underexpressed in SS (-1.48 and -2.3-fold, respectively) and NASH (-1.47 and -2.6-fold, respectively) versus LD. In NASH, hepatic ALDH1A2 and ALDH1A3 were underexpressed and inversely correlated with plasma retinol levels, which may reduce retinoic acid in the liver. This, in addition to changes in expression of other genes involved in retinol metabolism, suggests a role for altered retinol homeostasis in NASH.

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“…Part (usually inferiorly) or the entire cornea develops a dry, lusterless appearance secondary to epithelial metaplasia [21] during the evolution of NAFLD to combat reactive oxygen species and to reduce the oxidative stress. Supporting this relationship between oxidative stress and vitamin A is not only the fact that serum vitamin A levels usually drop in patients with NAFLD but also the fact that the severity of NAFLD is inversely correlated with vitamin A levels in the liver [31].…”

Section: Pathophysiologymentioning

confidence: 98%

Ophthalmic Complications of Bariatric Surgery

Guerreiro

Ribeiro

2014

OBES SURG

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Obesity is increasing vastly in the world, and the number of bariatric surgeries being performed is also increasing. Patients being submitted to bariatric surgeries, especially malabsorptive procedures, have an increased risk of developing nutrient deficiencies, which can culminate in symptomatic hypovitaminosis, if supplementation is not done correctly. The eye and the optic system need an adequate level of several vitamins and minerals to perform properly, especially vitamin A, and this article wants to cover the main nutrients involved, the possible ophthalmic complications that can arise by their deficiency, and the management of those complications.

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Association Between Liver Vitamin A Reserves and Severity of Nonalcoholic Fatty Liver Disease in the Class III Obese Following Bariatric Surgery

Abstract: This study confirms the association between liver retinol and degree of NAFLD, underscoring the need for further research in this area, to identify which patients might benefit from supplementation of vitamin A.

Cited by 43 publications

References 19 publications

Nocturnal hypoxia-induced oxidative stress promotes progression of pediatric non-alcoholic fatty liver disease

Nocturnal hypoxia-induced oxidative stress promotes progression of pediatric non-alcoholic fatty liver disease

Altered hepatic genes related to retinol metabolism and plasma retinol in patients with non-alcoholic fatty liver disease

Ophthalmic Complications of Bariatric Surgery

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