Effects of combined low‐dose spironolactone plus vitamin E vs vitamin E monotherapy on insulin resistance, non‐invasive indices of steatosis and fibrosis, and adipokine levels in non‐alcoholic fatty liver disease: <scp>a</scp> randomized controlled trial

Polyzos, Stergios A.; Kountouras, Jannis; Mantzoros, Christos S.; Polymerou, Vaia; Katsinelos, Panagiotis

doi:10.1111/dom.12989

Cited by 51 publications

(39 citation statements)

References 19 publications

(18 reference statements)

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“…The study by Aller et al did not clearly define the randomization strategy and included a combination therapy of vitamin E and silymarin tested against lifestyle modifications [16]. One double-blinded RCT compared a combination therapy of atorvastatin, vitamin C, and vitamin E and placebo [14]; the other double-blinded study compared vitamin E monotherapy and vitamin E combination therapy with spironolactone [17], and another compared δ-tocotrienol monotherapy therapy and placebo [18]. Three studies were triple-arm double-blinded RCTs where at least one group was given vitamin E as a monotherapy [13,15,19].…”

Section: Resultsmentioning

confidence: 99%

Vitamin E as an Adjuvant Treatment for Non-alcoholic Fatty Liver Disease in Adults: A Systematic Review of Randomized Controlled Trials

Usman

Bakhtawar

2020

Cureus

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Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease. It is characterized by a variety of pathologies, ranging from benign fatty liver to extensive fibrosis and even hepatocellular cancer. Among the several potential risk factors, insulin resistance and increased oxidative stress are the most important. Vitamin E is an antioxidant with a potential to be used as a treatment for NAFLD. Therefore, we carried out a structured systematic review of all RCTs conducted between 2010 and January 2020. After screening, eight RCTs were included. Our systematic review showed that vitamin E has clinical utility in improving biochemical (ALT and AST levels) and histological abnormalities in NAFLD (hepatic steatosis and lobular inflammation). However, vitamin E does not seem to have significant effects on liver fibrosis. Still, vitamin E has the potential to be used as an adjuvant for the treatment of NAFLD, and its use in clinical practice should be advocated.

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Section: Resultsmentioning

confidence: 99%

Vitamin E as an Adjuvant Treatment for Non-alcoholic Fatty Liver Disease in Adults: A Systematic Review of Randomized Controlled Trials

Usman

Bakhtawar

2020

Cureus

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“…An interventional study which demonstrated the beneficial effect of combined low dose of spironolactone plus vitamin E in patients with NAFLD did not report a significant decrease of leptin levels in the group which received the regimen [ 53 ]. Similarly, another study with rosiglitazone treatment in patients with NAFLD showed that the significant improvement in liver function was not accompanied by significant changes in plasma leptin levels [ 54 ].…”

Section: Leptinmentioning

confidence: 99%

Association of Adipokines with Development and Progression of Nonalcoholic Fatty Liver Disease

2018

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Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease affecting 30% of the general population and 40% to 70% of obese individuals. Adipose tissue plays a crucial role in its pathogenesis, as it produces and secretes pro- and anti-inflammatory cytokines called adipokines. Adiponectin and leptin have well-determined actions in terms of NAFLD pathophysiology. Adiponectin deficiency is associated with a pro-inflammatory condition, as it is observed in obesity and other metabolic disorders. On the other hand, increased leptin levels, above the normal levels, act as a pro-inflammatory stimulus. Regarding other adipokines (resistin, visfatin, chemerin, retinol-binding protein 4, irisin), data about their contribution to NAFLD pathogenesis and progression are inconclusive. In addition, pharmacological agents like thiazolidinediones (pioglitazone and rosiglitazone), that are used in the management of NAFLD exert favourable effects on adipokine levels, which in turn may contribute to the improvement of liver function. This review summarizes the current knowledge and developments in the association between adipokines and NAFLD and discusses possible therapeutic implications targeting the modulation of adipokine levels as a potential tool for the treatment of NAFLD.

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“…Yao et al demonstrated that silymarin ameliorated insulin resistance in NASH rats and proposed that this natural compound was able to modulate the expression of genes involved in visceral obesity, lipolysis and gluconeogenesis [48]. The same role was not delineated for vitamin E since the biomolecule alone seemed not able to repair damaged insulin response mechanisms [49]. Some mechanisms through which DHA exerts this property emerged from studies on animals: anti-inflammatory effects and modulation of the expression of related gene were proposed [50]; similarly, curbed insulin resistance was obtained by supplementation with only CGA in animals with HFD-induced hepatic steatosis [51].…”

Section: Discussionmentioning

confidence: 99%

Treatment of Non-Alcoholic Steatosis: Preclinical Study of a New Nutraceutical Multitarget Formulation

et al. 2020

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Multifactorial pathogenesis of non-alcoholic steatohepatitis (NASH) disease, a wide-spread liver pathology associated with metabolic alterations triggered by hepatic steatosis, should be hit by multitarget therapeutics. We tested a multicomponent food supplement mixture (AP-NHm), whose components have anti-dislipidemic, antioxidant and anti-inflammatory effects, on in vitro and in vivo models of NASH. In vitro, hepatic cells cultures were treated for 24 h with 0.5 mM oleic acid (OA): in the co-treatment set cells were co-treated with AP-NH mixtures (AP-NHm, 1:3:10 ratio) and in the post-injury set AP-NHm was added for 48 h after OA damage. In vivo, C57BL/6 mice were fed with high-fat diet (HFD) for 12 weeks, inducing NASH at 7th week, and treated with AP-NHm at two dosages (1:3 ratio) in co-treatment or post-injury protocols, while a control group was fed with a standard diet. In in vitro co-treatment protocol, alterations of redox balance, proinflammatory cytokines release and glucose uptake were restored in a dose-dependent manner, at highest dosages also in post-injury regimen. In both regimens, pathologic dyslipidemias were also ameliorated by AP-NHm. In vivo, high-dose-AP-NHm-co-treated-HFD mice dose-dependently gained less body weight, were protected from dyslipidemia, and showed a lower liver weight. Dose-dependently, AP-NHm treatment lowered hepatic LDL, HDL, triglycerides levels and oxidative damage; co-treatment regimen was anti-inflammatory, reducing TNF-α and IL-8 levels. Hepatic lipidic infiltration significantly decreased in co-treated and post-injury-AP-NHm-HFD animals. The multitarget approach with AP-NHm was effective in preventing and reducing NASH-related pathologic features, warranting for the clinical development of this compound.

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Effects of combined low‐dose spironolactone plus vitamin E vs vitamin E monotherapy on insulin resistance, non‐invasive indices of steatosis and fibrosis, and adipokine levels in non‐alcoholic fatty liver disease: a randomized controlled trial

Cited by 51 publications

References 19 publications

Vitamin E as an Adjuvant Treatment for Non-alcoholic Fatty Liver Disease in Adults: A Systematic Review of Randomized Controlled Trials

Vitamin E as an Adjuvant Treatment for Non-alcoholic Fatty Liver Disease in Adults: A Systematic Review of Randomized Controlled Trials

Association of Adipokines with Development and Progression of Nonalcoholic Fatty Liver Disease

Treatment of Non-Alcoholic Steatosis: Preclinical Study of a New Nutraceutical Multitarget Formulation

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