Lifestyle Intervention and Vitamin E Therapy in Obese Children with Nonalcoholic Fatty Liver Disease

Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) is a very common chronic disorder and obesity is thought to be the most common etiology of fatty infiltration of the liver. Objectives: The objective of this study is to compare the effect of lifestyle intervention alone or in combination with vitamin E therapy in obese pediatric nonalcoholic fatty liver disease (NAFLD). Patients and Methods: In the double-blind placebo study, 33 obese children with NAFLD from 2008 to 2009 were included. Lifestyle intervention (balanced calorie diet, 1300-1800 kcal/d and physical activity) was prescribed to all. The patients were concurrently randomized to receive vitamin E 400 mg/d (n = 17)] or placebo (n = 16). Results: At the end of six months of therapy there was significant change in body mass index, serum aminotransferases, triglycerides, total cholesterol and low density lipoprotein-cholesterol levels in both groups (P <0.001), but the improvement in all these factors was only marginally different between the two groups. Alanine aminotransferase decreased to normal levels in 8 of 17 patients (47.05%) in the lifestyle and vitamin E group, and 7 of 16 patients (43.75%) in lifestyle and placebo group. Similarly, the improvement in the grade of steatosis on ultrasonography after intervention was the same in both groups. Conclusions: lifestyle intervention with diet and physical exercise in obese children with NAFLD were induced weight loss and was associated with a significant improvement in liver function. Vitamin E did not seem to increase the efficacy of lifestyle intervention.