Abstract
Background: Despite the benefit of lifestyle changes, there is no standard treatment for Fibrotic NASH. However the concept of reversibility of liver fibrosis and cirrhosis with various natural biologically active compounds and antioxidant micro-nutrients is not new. Aim: The aim of this study was to compare effectiveness of Viusid® (a nutritional supplement) and Vitamin E in reducing steatosis and liver fibrosis score in patients with fibrotic NASH. Methods: 52 patients diagnosed with nondiabetic and noncirrhotic NASH on liver fibroscan were divided into 2 groups randomly and given Viusid® 3 sachets daily to 25 patients or Vitamin E 800 IU daily to 27 patients along with a hypocaloric diet and exercise for 3 months. Results: After 3 months treatment with Viusid®, as compared with Vitamin E, was associated with a significant reduction of both mean steatosis score (CAP value reduces from 286±16.3 to 208±18.5 dB/m in Viusid® group vs. from 278±14.4 to 253±12.1 dB/m in Vitamin E group; p 0.00001). Conclusions: Viusid® was superior to Vitamin E in reducing steatosis & fibrosis score in nondiabetic and noncirrhotic NASH patients. However, further large scale trial is needed to better assess the value of Viusid® for fibrotic NASH management.
Highlights
Nonalcoholic fatty liver disease (NAFLD) is defined as excessive fat accumulation in the liver without secondary hepatic fat accumulation such as significant alcohol consumption, use of steatogenic medication, or hereditary disorders [1]
After 3 months of treatment, significant improvements were seen in both endpoints from baseline data in Viusid® group compared to Vitamin E group (Figure 3)
The mean alanine transaminase (ALT) levels significantly decreased from 114±25.9 U/L to 43±9.1 U/L in Viusid® group compared to from 105±15.5 U/L to 55±11.7 U/L in Vitamin E group (p>0.00001)
Summary
Nonalcoholic fatty liver disease (NAFLD) is defined as excessive fat (i.e., triglyceride) accumulation in the liver without secondary hepatic fat accumulation such as significant alcohol consumption, use of steatogenic medication, or hereditary disorders [1] It is histologically categorized into nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). Modern western nutrition, and genetic predispositions have been identified as major causes of NAFLD These lead to liver injury via insulin resistance and an excess of free fatty acids in hepatocytes, resulting in oxidative stress and lipotoxicity (lipid-peroxidation) that promote the activation of intracellular stress kinases and apoptosis or necroapoptosis (NASH) [5]. Aim: The aim of this study was to compare effectiveness of Viusid® (a nutritional supplement) and Vitamin E in reducing steatosis and liver fibrosis score in patients with fibrotic NASH. Further large scale trial is needed to better assess the value of Viusid® for fibrotic NASH management
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